Periodontal Disease and Nonsurgical Periodontal Therapy on the OHRQoL of the Patient: A Pilot Study of Case Series

Patient self-reported perception and knowledge of periodontal disease: An observational, university-representative, survey-based analysis in an academic setting

BACKGROUND

Limited information is available about patient knowledge and perceptions of periodontal diseases. In this observational, survey-based study, the authors investigated patients' understanding of periodontal diseases and their experience after periodontal therapy using self-reported oral health-related quality of life.

METHODS

Patients receiving oral health care at the College of Dentistry, University of Oklahoma, were recruited and surveyed about topics related to general knowledge, etiopathogenesis, treatment outcomes, level of treatment satisfaction, and oral health-related quality of life in the context of periodontal diseases. The collected data were analyzed using descriptive and bivariate statistical methods.

RESULTS

A total of 190 surveys were collected. The results showed that 19.6% of patients did not know whether they had received a diagnosis of periodontitis and 13.7% were unaware whether they had undergone any treatment for it. Patients who reported having periodontitis had a better understanding of what a periodontal pocket was than healthy patients (79% vs 48%) and agreed smoking tobacco products could worsen the condition (92% vs 69%). Patients who had received a diagnosis of periodontal disease were more concerned about their teeth (eg, esthetics, tooth loss, function, and discomfort) than healthy patients (84.3% vs 58.9%). Lastly, a strong association was found between patients' total knowledge scores and positive attitude toward their dental health and periodontal therapy.

CONCLUSIONS

Patients generally have a limited understanding of their periodontitis diagnosis and treatment. However, those requiring advanced treatment had a better understanding of their condition compared with patients not treated for periodontitis.

PRACTICAL IMPLICATIONS

Clinicians will dedicate more time to patient education about periodontal diseases.

ORAL HEALTH IMPACT OF DENTAL HYGIENE AND DENTAL THERAPY PATIENT POPULATIONS-AN EVIDENCE UPDATE IN 2024

OBJECTIVES

Dental patient-reported outcomes, especially the Oral Health-Related Quality of Life (OHRQoL) construct, are vital for evidence-based dentistry. This construct includes four dimensions (4D): Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact. This study updates previous work characterizing 4D OHRQoL impairment among patients in dental hygiene (DH) and dental therapy (DT) settings.

METHODS

An expert panel revised previously determined DH and DT patient population groups to align them with current scopes of practice. An updated systematic review was then conducted to incorporate recent studies using the Oral Health Impact Profile (OHIP) to assess 4D OHRQoL in these populations. The search spanned 6 databases from January 1, 2023, to April 16, 2024.

RESULTS

The panel identified 20 patient populations, representing the scope of DH and DT practice. The systematic review contained 19 studies (17 from the previous review and 2 new ones). Studies' OHRQoL data covered only 30 % of dental hygiene and dental therapy patient populations identified by the panel. The most frequently studied group was "therapeutic periodontal treatment-patients with periodontitis" (n = 17, 89 %), followed by "oral hygiene instructions-all patients" (n = 13, 68 %). Only four studies provided 4D OHRQoL data, showing the greatest impacts in Orofacial Pain (baseline OHIP: 3.10-4.20; follow-up: 1.52-3.60) and Orofacial Appearance (baseline OHIP: 0.44-2.50; follow-up: 0.91-2.25). Among studies reporting summary OHIP scores only (n = 15), overall OHRQoL impairment ranged from 1.40 to 42.35 at baseline and 1.50-40.56 at follow-up. All studies demonstrated a general trend of reduced OHRQoL impairment over time with treatment. Risk of bias was low, with no evidence of publication bias.

CONCLUSION

Current evidence on OHRQoL impairment in DH and DT patient populations is limited, covering only a third of those treated by dental hygienists and therapists. Especially, scarce 4D OHRQoL data prompts the need for more research in this format. Despite these limitations, the findings show promising trends of reduced OHRQoL impairment over time for DH and DT patient populations.

The Relationship Between Dental Anxiety and Oral Health-Related Quality of Life in Patients with Periodontitis

OBJECTIVES

This study aimed to (1) investigate whether dental anxiety (DA) and oral health-related quality of life (OHRQoL) differed between patients diagnosed with periodontitis and individuals with periodontal health, (2) examine associations and correlations between these patient-reported measures, and (3) analyze demographic and clinical parameters.

METHODS

Ninety-six patients diagnosed with periodontitis and age- and sex-matched periodontally healthy controls were included. Participants' demographic characteristics, smoking status, current dental pain, dental pain during the last month, the Modified Corah's Scale (MDAS), and the Oral Health Impact Profile (OHIP-14) were determined.

RESULTS

The mean age of participants was 48.51 years ± 11.41. Patients with periodontitis experienced higher pain in the last month compared to controls (p = 0.003). Patients with periodontitis exhibited significantly higher MDAS total and sub-scores (p < 0.001). Compared to controls, the periodontitis group indicated extreme DA (1.04% vs. 7.79%, p = 0.034). Patients with periodontitis feared having a foreign object in the mouth compared to controls (p = 0.004). The periodontitis group exhibited worse OHIP-14 global and sub-scores (all Ps < 0.001). Positive associations and correlations of MDAS total and sub-scores with OHIP-14 global and domain scores were found for the periodontitis group, but not for controls. Patients with periodontitis who reported "moderate and extreme anxiety" had poorer OHRQoL compared to controls (p = 0.001). The minimal importance difference for this finding indicates a large effect size and a moderate standardized response mean between groups.

CONCLUSIONS

Patients with periodontitis had higher levels of DA and worse OHRQoL compared to controls. Our study highlights the importance of providing a comprehensive approach, including psychosocial well-being, when diagnosing and treating periodontal disease.

[Impact of self-reported periodontal status on oral health-related quality of life in adult population with Type 2 Diabetes from Mexico City]

OBJECTIVE

Periodontitis ranks sixth as a type 2 diabetes (T2D) complication. According to its severity, it may cause pain, discomfort and tooth loss. The aim of this study was to evaluate the impact of self-reported periodontal status on the Oral Health Related Quality of Life (OHRQoL) of people with T2D.

METHODS

A cross-sectional study was conducted involving seventy-nine adults with T2D who visited the Metabolic Syndrome clinic at the Cosío Villegas National Institute of Respiratory Diseases in Mexico City between August and November 2010. The OHRQoL was evaluated with the shortened Oral Health Impact Profile (OHIP-EE14). Periodontitis was measured by self-report, probing depth (PD), and clinical attachment loss (CAL). The association between self-reported periodontal status and OHRQoL was evaluated with binomial regression models.

RESULTS

Mean age of the participants was 60,4 years (SD=9,6); diabetes duration was 10,1 years (SD=6,6). The OHRQoL was associated with self-perception of bad breath (RR=1,58; p=0,025), self-perception of poor gum health (RR=1,66; p=0,016), dissatisfaction with chewing ability (RR=2,22; p≤0,001), tooth loss due to mobility (RR=1,74; p=0,019), and presence of 20 teeth or less (RR=1,57; p=0,045).

CONCLUSIONS

OHRQoL is associated with self-report of bad breath, poor gum health and dissatisfaction with chewing ability in people with T2D, which suggests that self-perceived oral conditions represent signs and symptoms of functional and psychological impairment related to severe periodontitis.

The oral health impact of dental hygiene and dental therapy populations: a systematic review

OBJECTIVES

Oral health-related quality of life (OHRQoL) is pivotal in patient care, reflecting oral health through dental patient-reported outcomes (dPROs). This systematic review aims to outline the 4-dimensional (4-D) impact of OHRQoL within patient populations routinely treated by dental hygiene and/or dental therapy providers, as there is limited literature present for these oral health care professionals.

METHODS

The study extracted and analyzed characteristics and multidimensional impact of OHRQoL, using the Oral Health Impact Profile (OHIP) as the primary dental patient-reported outcome measure (dPROM). The search strategy spanned 7 databases: Medline via the Ovid interface (Ovid MEDLINE(R) ALL), Embase via Ovid, Cinahl, APA PsycINFO via Ovid, Dentistry and Oral Sciences Search, Scopus, and Web of Science (Core Collection). It commenced September 2, 2022, with a refinement search on July 5, 2023. English language criteria yielded 645 articles postduplication removal. A screening procedure involving 3 reviewers encompassed title, abstract, and full-text review.

RESULTS

After application of inclusion and exclusion criteria, 5 articles were subjected to data extraction, capturing domain-specific information including baseline and follow-up OHRQoL data. An additional set of 13 articles containing summarized OHRQoL data underwent separate analysis. The Joanna Briggs Institute (JBI) critical appraisal tools were utilized for risk bias assessment of the included articles. The 4-D impact scores reported for baseline OHRQoL data, ranged from 3.10 to 4.20 for Oral Function, 0.84-2.70 for Orofacial Pain, 1.70-4.50 for Orofacial Appearance, and 0.44-2.50 for Psychosocial Impact. In follow-up OHRQoL data, the range for Oral Function was 1.52-3.60, Orofacial Pain 0.60-2.10, Orofacial Appearance 0.91-2.25, and Psychosocial Impact 0.10-0.60.

CONCLUSIONS

This review highlights a critical call for standardization in OHRQoL data collection for dental hygiene and dental therapy patient populations as only 26% of the predetermined distinct populations were found to have studies completed with 4-D impact of OHRQoL. Moreover, the presence of limited research in describing the multi-dimensional impact in patients routinely treated by these providers shows the urgency of substantive research in this area.