Oral Health-Related Quality of Life of Patients With Oral Lichen Planus, Oral Leukoplakia, or Oral Squamous Cell Carcinoma

The relationship between clinical symptoms of oral lichen planus and quality of life related to oral health

INTRODUCTION

Oral Lichen Planus (OLP) is a chronic and relatively common mucocutaneous disease that often affects the oral mucosa. Although, OLP is generally not life-threatening, its consequences can significantly impact the quality of life in physical, psychological, and social aspects. Therefore, the aim of this research is to investigate the relationship between clinical symptoms of OLP and oral health-related quality of life in patients using the OHIP-14 (Oral Health Impact Profile-14) questionnaire.

MATERIALS AND METHODS

This descriptive-analytical study has a cross-sectional design, with case-control comparison. In this study, 56 individuals were examined as cases, and 68 individuals were included as controls. After recording demographic characteristics and clinical features by reviewing patients' records, the OHIP-14 questionnaire including clinical severity of lesions assessed using the Thongprasom scoring system, and pain assessed by the Visual Analog Scale (VAS) were completed. The ADD (Additive) and SC (Simple Count) methods were used for scoring, and data analysis was performed using the T-test, Mann-Whitney U test, Chi-Square, Spearman's Correlation Coefficient, and SPSS 24.

RESULTS

Nearly all patients (50 individuals, 89.3%) reported having pain, although the average pain intensity was mostly mild. This disease has affected the quality of life in 82% of the patients (46 individuals). The patient group, in comparison to the control group, significantly expressed a lower quality of life in terms of functional limitations and physical disability. There was a statistically significant positive correlation between clinical symptoms of OLP, gender, location (palate), and clinical presentation type (erosive, reticular, and bullous) of OLP lesions with OHIP-14 scores, although the number or bilaterality of lesions and patient age did not have any significant correlation with pain or OHIP scores.

CONCLUSION

It appears that certain aspects of oral health-related quality of life decrease in patients with OLP, and that of the OLP patient group is significantly lower in terms of functional limitations and physical disability compared to the control group. Additionally, there was a significant correlation between clinical symptoms of OLP and pain as well as OHIP scores.

Changes in quality of life over time in patients diagnosed with oral leukoplakia: A prospective longitudinal study

BACKGROUND

Oral leukoplakia (OL) is one of the most prevalent oral potentially malignant disorders (OPMD). Although there is emerging evidence that quality of life (QoL) is impaired in subjects with OL; studies to date are based on single and heterogenous point-in-time assessments. The aim of this study was to ascertain if QoL scores change over time in individuals diagnosed with OL.

METHODS

Forty-one individuals with OL were administered the Short Generic Health Questionnaire (SF-12) and the discipline-specific Oral Potentially Malignant Disorder Questionnaire (OPMDQ) at four points in time: at the time of clinical diagnosis, at the post-biopsy review (confirmed diagnosis), and at 3- and 6-month follow-up appointments. Responses were compared between the four time points.

RESULTS

No significant differences were observed in the SF-12 questionnaire scores over time. However, a general improvement in the participants' life quality was evident over the 6-month period under investigation in the domains of psychological and social well-being (p = 0.0027) and effect of treatment on daily life (p = 0.0317) as well as in the total score (p = 0.0005) of the OPMDQ. Age, gender, medical status, tobacco/alcohol use, lesion site, size, the presence of dysplasia and treatment did not impact QoL scores over time.

CONCLUSIONS

QoL scores of OL subjects may improve with time. Our results suggest that studies examining QoL in individuals with OL should be controlled for time at which the participants are surveyed.

Quality of life in patients with oral potentially malignant disorders: oral lichen planus and oral epithelial dysplasia

OBJECTIVE

The aim of this study was to evaluate and compare quality of life (QoL) parameters in patients with oral potential malignant disorders (OPMDs), namely, oral lichen planus (OLP) and oral epithelial dysplasia (OED).

STUDY DESIGN

A cross-sectional study was completed at the oral maxillofacial surgery/oral medicine practices at University of Pennsylvania. Patients with clinical and histopathologic confirmation of OLP or OED from January to June 2021 were included in the study. The primary predictor variable was the OPMD type. The primary outcome variable was the score of 3 separate surveys: the Chronic Oral Mucosal Disease Questionnaire-26 (COMDQ-26), Oral Potential Malignant Disorder QoL Questionnaire (OPMDQoL), and Hospital Anxiety and Depression Scale. Multiple linear regression was used to determine independent predictors of increased/decreased questionnaire scores.

RESULTS

The final study sample consisted of 100 patients:53 patients had OLP (53.0%), 39 patients had OED (39.0%), and 8 patients had OLP with OED (8.0%). Relative to OED, OLP added 15.7 points to the COMDQ-26 survey score (P < .001). Relative to OED, OLP added 8.9 points to the OPMDQoL survey score (P = .003).

CONCLUSIONS

Oral lichen planus shows significantly poorer QoL specifically within the COMD-26 and OPMDQoL questionnaires, compared with OED. Additionally, patients with OPMDs aged 40 to 64 years were independently associated with higher COMD-26 scores compared with older patients (>65 years).

The Influence of Hepatitis C Virus Infection on ORAL Health-Related Quality of Life in Patients with Oral Lichen Planus

Background: oral lichen planus (OLP) is a mucocutaneous disease that affects about 4% of the global population. Hepatitis C virus (HCV) was linked to lichen planus. The current study aimed to assess the impact of OLP associated or not with HCV infection on the oral health-related quality of life (OHRQoL). Methods: The study included patients diagnosed with OLP who filled in the Romanian version of OHIP-14 questionnaire at their first appointment and 6 months later, after the OLP treatment. A control group of OLP-free subjects similar as age and sex was also included in the study. Results: 68 patients with OLP and 46 controls were included in the study. The OHIP scores are significantly higher on OLP group than controls (p-value < 0.0001) and significantly reduced at 6-month follow-up (p-values: < 0.0001 pre- vs. post-treatment in OLP group). Patients with and without HCV associated with OLP demonstrated a similar oral quality of life (p-values > 0.05). Conclusions: the OHRQoL for patients suffering from OLP is compromised but is improved after treatment. The HCV associated with OLP did not influence the overall OHRQoL, but the patients who associate HCV reported more frequently aching in the mouth and discomfort eating food at six-month follow-up.

Patient-reported pain after surgical removal of leukoplakia - an observational 1-year follow-up study

OBJECTIVE

Oral leukoplakia (OL) presents as a white lesion of the oral mucosa and is not typically associated with the sensation of pain. OL should be surgically removed when possible because it is considered a potentially malignant oral disorder (PMOD). This study assessed the pain sensations experienced by patients in association with the occurrence and surgical treatment of OL.

METHODS

Inclusion criteria were: a clinical diagnosis of OL; biopsy excision; and observation for at least 12 months in the ORA-LEU-CAN study. At the first visit, all the patients were asked about the occurrence of symptoms within the lesion. Ninety-four subjects were assessed over a period of 1 year. All patients underwent complete removal of OL. The patient cohort was divided into three sub-groups: (i) no pain before excision and at the 1-year follow-up; (ii) pain before excision; and (iii) pain at the 1-year follow-up.

RESULTS

Overall, pain was reported by 21.3% of the patients at the study start whereas 13.8% of the patients reported pain 1 year after surgical treatment. Patient-reported pain from the lesion at study inclusion was significantly associated with lesions found on the lateral side of the tongue (p=.002). Pain reported by patients one year after surgery was significantly related to female gender (p=.038) and the presence of epithelial cell dysplasia (p=.022).

CONCLUSION

We conclude that surgical removal of OL results in a low risk of long-term post-surgical pain. However, OL located on the lateral side of the tongue and in OL with dysplasia are more likely to be associated with pain.

Clinical characteristics of oral lichen planus and its causal context with dental restorative materials and oral health-related quality of life

Background

The aim of this study was to investigate the influence of clinical characteristics and dental restorative materials on oral health-related quality of life in patients with oral lichen planus. In particular, the influences of amalgam and metals were investigated.

Methods

A total of 112 patients with clinical and histological features of oral lichen planus from the Department of Cranio-Maxillofacial Surgery at the University Hospital of Münster participated in this prospective study. Clinical parameters of oral lichen planus and the dental restorative materials used were evaluated. Oral health-related quality of life was investigated by using the short form of the German version of the Oral Health Impact Profile (OHIP-14). In addition, physical pain was rated on a visual analogue scale.

Results

The average OHIP-14 score was 13.54. A high correlation was seen between OHIP and pain. Likewise, higher OHIP-values were seen for male patients, and such as for those patients with non-reticular forms of oral lichen planus (OLP). A local form of OLP is more often seen on female patients, such as with the presence of reticular lichen. In regard to the restorations, the presence of composite restorations is correlated with a local lichen, whereas the presence of gold restorations is often seen with a generalized lichen. Furthermore, the grading of strength of association between mucosal lesion and amalgam/metal was tested. No significant differences revealed the analysis of the relationship between gender, clinical form of OLP, age, and presentation form between the 4 gradings of Thornhill.

Conclusions

The oral health-related quality of life is significantly limited in patients with oral lichen planus. But these OHIP scores are not influenced by the restorative materials. Here, pain severity is the most important aspect. We found no statistical differences in the clinical parameters between patients with amalgam or metal restoration and patients without these restorations. It is not necessary to replace amalgam fillings that are not in direct contact with mucosal surfaces.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-021-01622-z.

Impact of Oral Lichen Planus on Oral Health-Related Quality of Life: A Systematic Review and Meta-Analysis

Oral health-related quality of life (OR-QoL) measurement in patients with oral lichen planus (OLP) can provide valuable information for the optimal management of their clinical conditions. The main objective of the present study was to assess the OR-QoL of patients with OLP as measured by the short-form Oral Health Impact profile-14 (OHIP-14) questionnaire. PubMed/MEDLINE, ISI/Web of Science, clinical trial registry, Embase, Scopus, and grey literature (via Google Scholar and Scilit) were searched. Reviewers independently screened titles/abstracts, assessed full-text articles, extracted data, and appraised their quality. Random effect analysis along with subgroup analysis for age, gender, and clinical type was performed. Seventeen studies were included. Mean overall OH-QoL was 15.20, [95% CI 12.176, 18.231]; a higher OHIP-14 score was seen in OLP patients, resulting in poor OH-QoL. The impact of OLP on OH-QoL life was moderate as compared to healthy subjects. However, medical treatment of the disease improved the OH-QoL and thus reduced the impact of OLP on it. OH-QoL among patients with OLP is generally poor. Clinicians and physicians should consider the OH-QoL of these patients as part of patients’ evaluation and modulate the administered treatment based on the OH-QoL response.

Psychosocial impacts of oral epithelial dysplasia

BACKGROUND

The psychosocial impact of receiving the diagnosis of oral epithelial dysplasia, which presents up to 3.5% increased annual risk of mouth cancer, remains unknown. Using validated instruments, the present study aimed to investigate the prevalence and existing correlations between anxiety, depression and dental anxiety symptoms and burden on oral health-related quality of life.

METHODS

A clinical cohort of 82 patients with oral dysplasia was asked to complete the Hospital Anxiety and Depression Scale, the Modified Dental Anxiety Scale and the shortened version of the Oral Health Impact Profile. Spearman's correlation coefficient and regression analyses were performed.

RESULTS

The participants' scores were in keeping with the presence of anxiety, depression and emotional distress symptoms in 30%, 16% and 26%, respectively. However, 69% experienced anxiety related to procedures that may be required as part of long-term management of oral dysplasia (e.g. local anaesthetic injection). The oral health-related quality of life scores showed 41.5% reporting a recent daily problem due to their oral or dental health. Significant correlations [p >0.05] were found among and between all of the used instruments. Being a female with oral dysplasia also predicted increased odds of indicating higher anxiety and dental anxiety scores than males [p >0.05].

CONCLUSION

Oral dysplasia can adversely impact on the psychosocial well-being of affected persons. Establishing a causal relationship between the measured variables may, however, be challenging and would need further longitudinal studies.

Oral health-related quality of life in oral cancer patients: systematic review and meta-analysis

Aim: The purpose of this meta-analysis was to evaluate the impact of oral health on quality of life in oral cancer patients (OCPs). Methods: PubMed, Scopus and Web of Science databases were searched for publications on oral health-related quality of life (OHRQoL) in OCP and the information was extracted according to the PRISMA guidelines. A random effect model was used to obtain the pooled standard mean differences of Oral Health Impact Profile (OHIP)-14 questionnaire responses in meta-analysis. Results: total of 12 research papers were analyzed and revealed poor OHRQoL in OCPs (standard mean difference: 2.53; 95% CI: 1.55-3.50; p < 0.00001) compared with healthy individuals due to the effects of oncotherapy. Moreover, OHRQoL deteriorated with combinations of different treatment modalities. Conclusion: Oral health and oncotherapy can affect the quality of life in OCPs.

Does the Clinical Form of Oral Lichen Planus (OLP) Influence the Oral Health-Related Quality of Life (OHRQoL)?

(1) Background: The aim of the study was to investigate the oral health-related quality of life (OHRQoL) of patients with oral lichen planus (OLP) and to evaluate differences between the various clinical forms of OLP. Specifically, the differences in OHRQoL, physical pain levels and eating restriction were assessed; (2) Methods: One hundred and twelve patients with clinical and histological features of OLP from the Department of Cranio-Maxillofacial Surgery of the Münster University Hospital participated in this prospective study. OHRQoL was analysed by using the German short version of the Oral Health Impact Profile (OHIP-14). Physical pain levels and restriction in eating were rated on visual analogue scales (VAS). The statistical analysis was performed using the Mann-Whitney U-Test and the chi-squared test with a significance level at p = 0.05; (3) Results: Group 1 consisted of patients with reticular OLP (n = 50) and group 2 of patients with atrophic, erosive-ulcerative or bullous OLP (n = 62). The average OHIP-14 score was 13.54 points and differed significantly between the two groups. There were significant differences in the domains "physical pain", "psychological discomfort", "physical disability" and "social disability". The VAS "physical pain" score and "restriction in eating" score varied significantly between the clinical forms. Positive correlations were found between the OHIP-14 total scores and the VAS scores; (4) Conclusion: The OHRQoL is significantly limited in patients with OLP; especially, patients with erosive-ulcerative OLP are affected.

Health-related quality of life and its associated predictors in patients with oral lichen planus: a cross-sectional study

OBJECTIVES

To investigate levels of quality of life (QoL) and determine associated predictors in patients with oral lichen planus (OLP).

MATERIALS AND METHODS

A total of 300 patients with OLP at one tertiary Oral Medicine clinic in the UK were recruited in a cross-sectional study from January 2018 to July 2019. The 15-item Chronic Oral Mucosal Disease Questionnaire (COMDQ-15) and 14-item Oral Health Impact Profile (OHIP-14) were used to assess the level of QoL related to OLP. A number of potential determinants were considered, including patient demographics, treatment, the severity of oral symptoms, the clinical activity of the disease, and the patient psychological status, which were measured using the pain-Numerical Rating Scale, the Oral Disease Severity Score, the Hospital Anxiety and Depression Scale, and the 10-item Perceived Stress Scale. Multivariate linear regression was employed to identify independent determinants associated with overall and aspects of QoL.

RESULTS

On multivariate analyses, after adjusting for confounding variables, the QoL levels in patients with OLP were significantly associated with levels of oral pain, anxiety, stress and use of topical corticosteroids. The COMDQ-15 instrument performed better than OHIP-14 at capturing the association between QoL and pain and disease activity in patients with OLP.

CONCLUSION

Clinicians should expect reduced QoL in OLP patients with high pain levels, high anxiety levels, high perceived stress and use of topical corticosteroids. The COMDQ-15 is best suited to measure QoL in this population.

The impact of medication-related osteonecrosis of the jaws on the quality of life in cancer patients

Background

To evaluate the impact of oral health on the quality of life (QOL) of individuals undergoing cancer treatment at the time of diagnosis of medication-related osteonecrosis of the jaw (MRONJ).

Material and Methods

The present cross-sectional study analyzed patients with MRONJ from 2013 to 2019. The collected data included demographic data, base disease, medications associated with MRONJ, route of administration and time of use, signs, symptoms, and tomographic features of acute MRONJ, staging according to American Association of Oral and maxillofacial Surgeons position paper 2014 (AAOMS), type of dental treatment performed, outcome, and the responses to the Oral Health Impact Profile questionnaire (OHIP-14). Statistical analysis was performed using the Tukey test to study the association between oral condition and the QOL. A p-value of less than 0.05 was considered statistically significant.

Results

The sample consisted of 16 medical records of patients with MRONJ. Psychological discomfort showed alarmingly significant results (p< 0.001) with strong negative impact on the QOL of the patients. Functional limitation was the least affected dimension (p = 0.747). The other dimensions did not show statistically significant results.

Conclusions

MRONJ compromises oral health and negatively impacts the QOL, especially with respect to the psychological discomfort (worry and stress). The OHIP-14 questionnaire proved to be an effective tool in the assessment of this impact. Key words:Medication-related osteonecrosis of the jaw, quality of life, oral health, OHIP-14.

Topical rapamycin versus betamethasone dipropionate ointment for treating oral erosive lichen planus: a randomized, double-blind, controlled study

BACKGROUND

Although superpotent topical corticosteroids are the first-line treatment for oral erosive lichen planus (OELP), topical rapamycin was found efficient in a previous case series.

OBJECTIVES

To compare the efficacy and safety of topical rapamycin and betamethasone dipropionate ointment for OELP in a randomized, double-blind trial.

METHODS

Patients were randomized to receive treatment with betamethasone dipropionate ointment 0.05% in Orabase^® or topical rapamycin solution (1 mg/mL) on lesions twice daily for 3 months, followed by 3 months of observation. The primary outcome was clinical remission after 3 months of treatment. Secondary outcomes were clinical remission after 1 and 2 months, reduced oral pain and reduced impact on food intake after 3 months, clinical recurrence after treatment withdrawal, and adverse events.

RESULTS

During a 4-year period, 76 patients were randomized and 75 received treatment (rapamycin, n = 39; betamethasone, n = 36). At 3 months, 39.4% of patients with betamethasone and 27.3% with rapamycin showed clinical remission (odds ratio 0.68, 95% CI [0.24; 1.89]; P = 0.46). Rates of remission after 1 and 2 months, reduction in pain and impact on food intake after 3 months, were higher with betamethasone than rapamycin. Recurrence of oral erosions was similar between groups. Adverse events occurred in 43.6% of patients with rapamycin (mostly burning sensation, impaired taste) and 27.8% with betamethasone (mostly oral candidiasis).

CONCLUSION

Although the study was limited by insufficient recruitment, we did not find any superiority of topical rapamycin over betamethasone dipropionate ointment for OELP. Given the rapid remission and pain improvement in the betamethasone group, it appears that superpotent topical corticosteroids should remain the first-line treatment for OELP.

Oral lichen planus: a novel staging and algorithmic approach and all that is essential to know

Lichen planus (LP) is a chronic autoimmune disease. Oral lesions may occur in isolation or in combination with other affected muco-cutaneous sites. Oral LP (OLP) may present as one of the various manifestations of LP or may present as a disease sui generis with a broad range of severity. Despite this disease targeting the oral mucosa, its great impact on quality of life is underrated. In this article, we provide an updated review of the pathophysiology and epidemiology of OLP and offer guidance for its diagnosis and management. We also propose an algorithmic approach to the clinical forms of OLP and a novel staging system to facilitate management decisions.

Clinicopathologic data of individuals with oral lichen planus: A Brazilian case series

Background

The aim of the present series was to analyze the sociodemographic characteristics, clinicopathologic features, and oral health-related quality of life of 41 individuals with oral lichen planus (OLP).

Material and Methods

In a retrospective analysis (1998-2018), individuals with a clinical diagnosis of OLP from a referral service of Oral Medicine of Brazil were invited for follow-up. The individuals were assessed using the Oral Health Impact Profile-14 (OHIP-14) form. Histopathological data were reviewed according to the latest criteria proposed by the American Academy of Oral and Maxillofacial Pathology (AAOMP/2016).

Results

This series mainly consisted of females (70.7%) in their forties (31.7%). The buccal mucosa (68.2%) was the most commonly affected site. Reticular (56.1%) and erosive (34.3%) appearances were the most frequent. According to OHIP-14, individuals with OLP at multiple sites in the oral cavity showed worse values in the handicap domain and those who did not respond to corticosteroids showed a higher score on the psychological discomfort domain.

Conclusions

The findings of the present study, using the AAOMP/2016 criteria, agree with case series and retrospective studies reported in the literature. Besides, OLP in its more severe clinical forms had an influence on patient quality of life.

Key words:Diagnosis, epidemiology, oral lichen planus, oral mucosa, quality of life.

Adjuncts for the evaluation of potentially malignant disorders in the oral cavity: Diagnostic test accuracy systematic review and meta-analysis-a report of the American Dental Association

BACKGROUND

Oral squamous cell carcinoma is the most common manifestation of malignancy in the oral cavity. Adjuncts are available for clinicians to evaluate lesions that seem potentially malignant. In this systematic review, the authors summarized the available evidence on patient-important outcomes, diagnostic test accuracy (DTA), and patients' values and preferences (PVPs) when using adjuncts for the evaluation of clinically evident lesions in the oral cavity.

TYPES OF STUDIES REVIEWED

The authors searched for preexisting systematic reviews and assessed their quality using the Assessing the Methodological Quality of Systematic Reviews tool. The authors updated the selected reviews and searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials and DTA and PVPs studies. Pairs of reviewers independently conducted study selection, data extraction, and assessment of the certainty in the evidence by using the Grading of Recommendations Assessment, Development and Evaluation approach.

RESULTS

The authors identified 4 existing reviews. DTA reviews included 37 studies. The authors retrieved 7,534 records, of which 9 DTA and 10 PVPs studies were eligible. Pooled sensitivity and specificity of adjuncts ranged from 0.39 to 0.96 for the evaluation of innocuous lesions and from 0.31 to 0.95 for the evaluation of suspicious lesions. Cytologic testing used in suspicious lesions appears to have the highest accuracy among adjuncts (sensitivity, 0.92; 95% confidence interval, 0.86 to 0.98; specificity, 0.94; 95% confidence interval, 0.88 to 0.99; low-quality evidence).

CONCLUSIONS AND PRACTICAL IMPLICATIONS

Cytologic testing appears to be the most accurate adjunct among those included in this review. The main concerns are the high rate of false-positive results and serious issues of risk of bias and indirectness of the evidence. Clinicians should remain skeptical about the potential benefit of any adjunct in clinical practice.

Quality of life in patients with oral leukoplakia

BACKGROUND

Oral leukoplakia (OL) is the most common oral potentially malignant disorder, yet despite its chronic and potentially disabling nature, the literature concerning impacts of OL on quality of life (QoL) is limited. This study aimed to evaluate QoL in subjects with OL compared to controls using QoL questionnaires.

METHODS

Fifty individuals with OL and 50 controls matched for age, gender, smoking, and alcohol use were administered the Short Generic Health Questionnaire (SF-12) and the discipline-specific Oral Potentially Malignant Disorder Questionnaire (OPMDQ). Responses were compared between the two groups.

RESULTS

Subjects with OL reported poorer QoL scores compared to controls in two domains "Role limitations due to physical problems" and "Pain" of the SF-12 questionnaire, and in two domains "Difficulty with diagnosis" and "Effect of treatment on daily life" and in the overall scores of the OPMDQ. Females reported poorer QoL in the overall OPMD QoL score and in the domains of "Physical and function limitation" and "Psychological and social well-being," while older individuals in the domains of "Physical and function limitation" and "Effect of treatment on daily life." Non-alcohol drinkers and subjects with dysplastic or non-homogeneous OLs also reported poorer QoL scores.

CONCLUSIONS

Quality of life assessments provide useful insight into the impact of OL on an individual's life and opportunity to improve clinical care.

Quality of life assessment in temporomandibular joint ankylosis patients after interpositional arthroplasty: a prospective study

Temporomandibular joint (TMJ) ankylosis significantly impacts both physical and psychosocial patient wellbeing. A complete evaluation of treatment outcomes necessitates knowing the extent to which a patient's quality of life (QoL) is impacted. This study was performed to evaluate the impact of TMJ ankylosis on QoL in 25 TMJ ankylosis patients treated by interpositional arthroplasty. The patients completed OHIP-14 and UWQoL questionnaires once before and then at 3 months after the surgery. There was a significant improvement in mean cumulative scores for both questionnaires. With the exception of functional limitation, all OHIP domains showed significant improvement. Preoperatively, the worst scores were found in the psychological distress domain, followed by the social handicap, physical pain and physical disability domains. More than half of the subjects (56%) reported having suicidal thoughts. Amongst the individual UWQoL domains, appearance, chewing, anxiety (P <  0.01), recreation and mood (P <  0.05) showed improved scores. Appearance and chewing were the top ranked priority domains before and after surgery. No significant change was found in speech, taste, sleep, or breathing. Psychosocial factors were found to play a much bigger role than previously thought. The physical, psychological, and social factors were intricately related and dynamically interacted with each other. Surgical treatment produced a definitive QoL improvement in the patients.

Oral health-related quality of life in different clinical forms of oral lichen planus

OBJECTIVES

The aim of the study was to determine the prevalence of clinical forms in a group of oral lichen planus (OLP) patients and to investigate whether the oral health-related quality of life (OHRQoL) of patients with common clinical OLP forms differs significantly from that of other clinical forms of OLP and healthy patients, respectively.

METHODS

OHRQoL was assessed using the Romanian version of the short form of the Oral Health Impact Profile (OHIP-14). OLP patients rated the pain they were currently experiencing on a visual analog scale (VAS). Statistics was performed using parametric and non-parametric tests and multiple linear regression.

RESULTS

Eighty OLP patients and 80 healthy controls were enrolled. The most prevalent OLP clinical form was keratotic form (n = 39, 48.75%, group 1), followed by atrophic (31.25%), erosive-ulcerative (17.5%), and bullous (2.5%) forms, which were included in group 2 (n = 41). The OHRQoL did not differ significantly between group 1 and the other two groups. A negative social impact was reported on psychological discomfort domain for both OLP groups, as compared with healthy controls. VAS scores were significantly associated with OHIP total scores in group 1 (rho = 0.41, n = 39, p = 0.009, Spearman's correlation coefficient). Within the same group, significantly higher OHIP total scores were recorded in patients lacking academic education (p = 0.0086, Mann-Whitney U test).

CONCLUSIONS

Overall, the most common clinical OLP form did not impact significantly the OHRQoL of OLP patients.

CLINICAL RELEVANCE

Psychological therapy and meeting the educational needs might improve the OHRQoL of patients with common clinical forms of OLP.

Oral health related quality of life and determinant factors in patients with head and neck cancer

BACKGROUND

The present study aimed to measure the impact of oral health on the quality of life of patients with head and neck cancer.

MATERIAL AND METHODS

A cross-sectional study was conducted with 130 patients diagnosed with head and neck cancer at two medical centers. Participants answered a sociodemographic questionnaire and the Oral Health Impact Profile - 14 (OHIP-14). Clinical aspects, cancer staging, and treatment approach were also investigated. Mann-Whitney and Kruskal-Wallis non-parametric tests were used for statistical analysis, followed by Poisson regression analysis (with robust error variance), to associate the OHIP-14 scores with independent variables.

RESULTS

The OHIP-14 presented good internal consistency (Cronbach's Alpha = 0.861). The mean score obtained was 19.52 (±11.79). Physical pain (3.70±2.44), physical disability (3.26±2.62) and functional limitation (3.24±2.45) were ranked as the main factors affecting the quality of life. Patients non-Caucasians (PR = 1.30; IC 95% = 1.07-1.58; p = 0.009), widowers (PR = 1.36; IC 95% = 1.13-1.64; p = 0.001), diagnosed with squamous cell carcinoma (PR = 1.28; IC 95% = 1.05-1.58; p = 0.017) and with temporomandibular pain (PR = 1.31; IC 95% = 1.08-1.60; p = 0.007) were more likely to exhibit lower rates of quality of life.

CONCLUSIONS

The results showed a high impact of the oral health in the quality of life of patients with head and neck cancer was observed. Sociodemographic and clinical characteristics can exert influence on the quality of life of patients with head and neck cancer.

Impact of oral potentially malignant disorders on quality of life: a systematic review

Although oral potentially malignant disorders (OPMDs) are relatively common and potentially debilitating, literature on quality of life (QoL) in these patients is scanty. The purpose of this paper is to systematically review the literature on QoL in patients with OPMDs. A total of 210 titles were retrieved from electronic and manual databases searched from 1960 until September 2017. Out of these, 25 met our strict inclusion criteria as per the preferred reporting items for systematic reviews and meta-analyses guidelines. Most studies have assessed QoL in patients with oral lichen planus, reports of which cannot be generalized to all patients with OPMD. The findings of the studies differ but, overall, do not provide evidence that OPMD patients have a poorer QoL than healthy subjects.

Oral health impact profile of head and neck cancer patients after or before oncologic treatment: an observational analytic case-control study

PURPOSE

The objective of this study was to investigate the impact of oral health on the quality of life of patients with head and neck cancer (HNC) before and after oncologic treatment.

METHODS

Forty cancer-free individuals (Cf group) and 40 HNC patients (Hnc group) were included in this study. Hnc group was also divided into two subgroups: Hnc 1 (pre-cancer therapy, n = 20) and Hnc 2 (post-cancer therapy, n = 20). Participants were asked to complete a short form of Oral Health Impact Profile (OHIP-14). The results were statistically analyzed with the multivariate analysis of variance with post-hoc Scheffé multiple comparison.

RESULTS

It was observed a moderate impact on the quality of life on HNC patients, with values on Hnc 2 group significantly higher in the functional limitation when compared to the Hnc 1 group (p < 0.05). When compared to the Cf group, the values found on Hnc group were higher on functional limitation (p < 0.01) and at the total score (p < 0.05), whereas Hnc 2 group had significant superior values on functional limitation (p < 0.01), physical pain (p < 0.05), and total score (p < 0.01) CONCLUSION: These results show that there is an oral impairment that depreciates the quality of life of patients with an experience of HNC, principally after treatment, indicating the importance of the inclusion of professionals responsible for dental and oral care with the oncologic team to monitor the oral condition of these patients.

Smokeless tobacco and oral potentially malignant disorders in South Asia: a protocol for a systematic review

INTRODUCTION

Oral potentially malignant disorders (OPMDs) are chronic lesions or conditions characterized by a potential for malignant transformation. Apart from being possible pre-cursors to oral cancer, OPMDs themselves are usually painful and debilitating conditions having an influence on the quality of life, both in terms of pain and social disability. Smokeless tobacco (SLT) use is considered a major risk factor for OPMDs. SLT use is a culturally and socially acceptable habit in South Asia. According to a recent report, 90 % of the SLT burden of the whole world lies in the South Asian countries of Pakistan, India, Sri Lanka, Bangladesh, Bhutan, Nepal, Afghanistan, and Maldives. This review aims to assess the association between the use of various SLT products in South Asia and risk of OPMDs.

METHODS

This review will focus on epidemiological studies on the use of SLT and risk modification for OPMDs, which have been carried out in the human population of South Asian countries. Articles reporting estimates of relative risk, e.g., odds ratio (OR) or relative risk (RR) with their 95 % confidence intervals (CI) for SLT users versus non-users. Articles reporting data from which these effect estimates can be computed will be included in the review. We will search MEDLINE, the Science Citation Index (SCI), Scopus, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases for relevant literature using a combination of keywords and MeSH terms, where applicable. Appropriate sources of gray literature will also be included in the search. The electronic searches will be supplemented by a hand search of the bibliographies of the included articles. The included studies will be assessed for their quality using an established quality assessment tool. All relevant data from the included articles will be recorded in an MS Excel spread sheet and then transferred to Rev Man 5.3 to carry out a meta-analysis. Heterogeneity among the estimates will be assessed through the I (2) statistic. Sensitivity and subgroup analysis will be carried out to see the effects of individual or group of studies on the pooled effect estimate. Results of the review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

DISCUSSION

This review may have a potential limitation with regard to the designs of the studies included as we expect that most of the included studies will be of the observational types. We will however try to address this issue by conducting sensitivity and subgroup analysis of similar quality studies.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42015029705 .