Determinants of Health-Related and Oral Health–Related Quality of Life in Adults With Orofacial Clefts

Objectives: To investigate the structural and intermediary determinants of health-related quality of life (HRQoL) and oral health–related quality of life (OHRQoL) among adults with cleft lip and/or palate (CL/P). Design and Participants: A cross-sectional study was conducted with patients enrolled at the referral center for craniofacial anomalies in Manaus, Brazil. Adults aged 18 years or more with nonsyndromic CL/P were selected. Main Outcome Measures: Both HRQoL and OHRQoL were assessed using the 36-item Short-Form Health Survey and the Oral Impacts on Daily Performance, respectively. Individual interviews and oral examinations were conducted to collect data on socioeconomic and demographic characteristics, social ties, health-related behaviors, compliance of CL/P protocol, chronic diseases, type of CL/P, oral clinical measures, and CL/P-related measures. Poisson regression was used to test the association of independent variables with HRQoL and OHRQoL outcomes. Results: The mean age of the 96 participants was 29.4 ± 9.1 years. Low family income, female sex, low social support, type of CL/P, and dental caries were associated with poor HRQoL and poor OHRQoL ( P < .05). Poor HRQoL was also associated with chronic diseases ( P < .05). Adults with low education, low social network, and smokers were more likely to have worse OHRQoL ( P < .05). Conclusions: Structural and intermediary determinants were related to HRQoL and OHRQoL in adults with CL/P, suggesting the need for interdisciplinary approaches to improve the management of CL/P and intersectoral actions to reduce the impact of social inequalities.