these conditions may be life - threatening ( e.g. oral cancers ) or not , progressing ( caries , periodontitis , etc . ) or not , dealing with aesthetics ( staining in anterior teeth such as molar 
incisor hypomineralisation ( mih ) ) or pain ( pulpitis , mih in posterior teeth , etc . ) .
ohrqol is highly subjective and has to be assessed within the framework of patients conditions , sociocultural environments and own experiences and states of mind : because ohrqol is related to daily life and is unique to each individual , even patients with severe conditions can report having good quality of life .
furthermore , quality of life is by itself multi - faceted , showing variation over time for each individual .
ohrqol should therefore be assessed longitudinally to take into account changes over time , using versatile tools .
this means having relevant questions with well - defined items and being able to analyse answers in a good way .
many limitations can be found to the current validation testing , including relevance of the questions , validity and sensitivity to change , risk of misinterpretations ( role of the ethnocultural environment ) , problems of translation of english questionnaires and difficulty to interpret the significance of a psychometric measurement when reported simply as a numerical score or a mean [ 1 , 2 ] .
this latter point is of importance since the same score can be obtained from people answering in a different way to a majority of questions . finally , patient - based outcome measures ( as named by fitzpatrick et al . )
should provide the opportunity to measure the extent or intensity of the changes in ohrqol .
various psychometric instruments have also been used to measure ohrqol ( tables  1 and 2 ) [ 1 , 4 ] .
these are based on different criteria that enable them to be more or less patient- or expert - centred .
some are generic ( ohip1 - 49 , ohip-14 , oidp , oh - qol , sf-362 ) and can be considered as core indicators ; others are adapted to specific conditions / domains ( orthognathic qol questionnaire , sooq for orthodontic surgery , ohip - aesthetic,3 ohrqol for dental hygiene ) or populations ( cohqol and child - oidp for children , gohai for elderly people , etc.).table 1conceptual and structural basis of psychometric instruments used in dentistry ( adapted from brondani and mcentee ) instrumentsacronymstructural originsempirically basedconnotation of questionsnumber of questionssocial impacts of dental diseasesiddsipyesn14oral health impact profileohipicidhyesn49geriatric ( generic ) oral health assessment indexgohaiicidh and sipyesn and p12oral health - related qol instrumentohrqlmultiplenon36oral impact on daily performancesoidpicidhnon8dental impact on daily livingdidlsipyesn and nt and p36dental impact profiledipsipyesn and nt and p25oral health - related quality of life measureohqolmultiplenon3oral health quality of life inventoryoh - qolsipunclearp15rand dental questionnaireunspecifiedsipnon3oral health questionnaireunspecifiedicidhunclearn and nt and p70oral health quality of life ukohqol - ukicidh2yesn and p16subjective oral health status indicatorssohsimultiplenon and nt34liverpool oral rehabilitation questionnairelorqunclearnon40self - rated oral healthsrohicidhnon and p3dentaldentalunclearnon15dental health status quality of life questionnaireds - qolgeneric qol instrumentnon and punclearn 1/4 negative , nt neutral , p positive , sip sickness impact profile , icidh international classification of impairments , disabilities and handicapsinformation derived from open - ended interviewssome indicators present shorter or extended forms other than the original versionhealth - related models : natural history of disease model and sipdeveloped from existing measures ( rand , oral facial pain index , etc.).table 2oral health outcome measures developed before 2007 ( adapted from locker and allen ) pre-1997 ( presented at the 1997 conference ) social impacts of dental diseasegeneral ( geriatric ) oral health assessment index ( gohai)dental impact profile ( dip)oral health impact profile ( ohip)oral impacts on daily performances ( oidp)subjective oral health status indicators ( sohsi)oral health - related quality of life measuredental impact on daily living ( didls)oral health quality of life inventoryrand dental questionspost-1997ohqol - ukchild oral health quality of life questionnaire ( cohqol)child oidpohrqol for dental hygieneorthognathic qol questionnairesurgical orthodontic outcome questionnaire ( sooq ) conceptual and structural basis of psychometric instruments used in dentistry ( adapted from brondani and mcentee ) n 1/4 negative , nt neutral , p positive , sip sickness impact profile , icidh international classification of impairments , disabilities and handicaps information derived from open - ended interviews some indicators present shorter or extended forms other than the original version health - related models : natural history of disease model and sip developed from existing measures ( rand , oral facial pain index , etc . ) .
oral health outcome measures developed before 2007 ( adapted from locker and allen ) the ohip , also called ohip-49 , is the most widely used , and this has enabled investigators to modify forms that can be subsequently adapted to populations or conditions .
the initial 49-question form was constructed to assess the  social impact of oral disorders .
each of the set of 49 statements represented one of seven domains : it is mainly expert - centred and constructed to select items according to their fit with a conceptual framework rather than on the basis of their importance to the patients from whom they were derived .
a shorter version of ohip restricted to 14 items ( ohip-14 ) was later proposed .
one major question is to know if we need to use either a generic questionnaire , an adapted form of a generic questionnaire or to construct a new questionnaire specific to the population or condition to be studied .
constructing or using one of these specific questionnaires may lead to many questions , for example , ( 1 ) is it made specifically for the purpose of research or for clinical practice ? or ( 2 ) how to adapt each questionnaire to local languages and cultures ?
this may subsequently lead us to consider the impact of dentin hypersensitivity ( dhs ) or exposed cervical dentin ( ecd ) on ohrqol of those individuals being assessed .
very few studies have been devoted to this aspect of dhs / ecd as recently shown , with only two papers written in english specifically dedicated to the evaluation of ohqol in dhs / ecd patients .
one paper provided results using a generic questionnaire   and the second paper constructed a specific questionnaire to evaluate ohqol in dhs / ecd patients but provided no epidemiological results . these studies are more extensively described in an accompanying paper . in the future ,
studies using validated questionnaires specifically constructed to evaluate the impact of the condition on ohqol should be employed .
these questionnaires should be patient - centred and derived from interviews with patients who are expected to complete the questionnaire [ 4 , 10 ] . furthermore , if these studies also attempt to evaluate the efficacy of desensitising agents in reducing dhs / ecd and its subsequent impact on ohqol , then it is imperative that the condition should be clearly diagnosed by trained and calibrated dentists experienced in conducting clinical studies using recognised and accepted clinical criteria for the evaluation of dhs / ecd . due to the cultural and language differences between countries ,
there is also a need of norm or reference value(s ) for each population to be studied .
for example , when constructing a questionnaire for a non - english - speaking population , the questionnaire should be initially written in english , then translated by two people of the designated native ( foreign ) language and subsequently translated back into english by two native english - speaking people to identify any potential issues that may have arisen from the translation . finally , as indicated above , any future study attempting to evaluate the efficacy of a desensitising agent in reducing dhs / ecd and its subsequent impact on ohqol
should be conducted by experienced and calibrated examiners using established guidelines for conducting dhs / ecd clinical studies .
such studies should also be based on a randomised clinical study design and include both placebo or control groups .
patients suffering from dhs / ecd have been reported to have a significantly impaired ohrqol ; this may however be improved following treatment with a desensitising agent as reported by several authors .
it is therefore of the upmost importance that the use of the ohrqol as a quality control tool in the dental office be established in robust clinical studies .
furthermore , because of its ability to reflect a patient s satisfaction with any proposed treatment , it may prove to be a valuable asset for practitioners when assessing their patients quality of life before , during and after treatment of various clinical conditions such as dhs / ecd .
 objectivesoral health - related quality of life ( ohrqol ) can be considered as the scientific expression of that part of a person s well - being that is affected by his / her oral health . 
 the aim of this paper was to evaluate how to use the data available in the field of research to make a link between ohrqol and dentin hypersensitivity ( dhs ) in the dental office.materials and methodsresearch papers in the field of ohrqol and dhs and reviews and research papers about ohrqol were used for analysis in this short review , with a particular insight on the instruments used to evaluate ohrqol.resultsvarious psychometric instruments have been used to measure ohrqol that are more or less patient- or expert - centred . 
 some are generic , others are adapted to specific conditions / domains or populations . 
 the impact of dhs or exposed cervical dentin ( ecd ) on ohrqol has been assessed in very few studies . 
 it is therefore of the upmost importance that the use of the ohrqol as a quality control tool be established in robust clinical studies.conclusions/clinical relevancefuture studies evaluating the impact of the dhs / ecd on ohqol or evaluating the efficacy of desensitising agents should respect some key points , including study design ( randomization , placebo / control group , etc . ) , validated specific questionnaires and trained calibrated practitioners . 
Why is it difficult to evaluate OHRQoL?
How to assess OHRQoL?
DHS/ECD and OHRQoL: what is known and where are the problems?
What are the recommendations for daily dental practice?
Conflict of interest