歯科

概要

Periodontal Status and its Impact on Oral Health Related Quality of Life (OHRQOL)

Syeda Natasha Zaidi, Farzeen Tanwir, Saima Mazhar, Kulsoom Fatima Rizvi, Sidra Farooqui, Umair Aslam

Introduction: Periodontitis is a common infection that damages soft and hard tissues of the oral cavity, with an age-standardized prevalence of 11.2%. The factors causing this disease are Diabetes Mellitus (DM), smoking and, most commonly, poor oral hygiene. As periodontal disease progresses, signs such as swollen and bleeding gums and, ultimately, tooth mobility due to loss of support become apparent and possibly painful. Quality of life refers to one’s perceptions about life, both positive and negative, because of the cultural context in which one lives. Quality of life encompasses several domains, including psychological functioning and social relationships among others. Oral Health-Related Quality of Life (OHRQoL), i.e., quality of life specific to oral health and the impacts of oral health) has been shown to be reduced in patients with periodontal disease. Therefore, this study will help to find out the burden of periodontitis among the patients visiting dental OPD and dental counseling from dentist regarding maintaining oral hygiene may prevent from further damage and destruction of periodontal tissue and its health. Objective of the study: To determine the clinical periodontal status and its impact on quality of life of patients visiting dental OPD. Materials and method: A cross-sectional analytical study was conducted from January to June 2018 among 320 patients at Bahria University of Medical and Dental College (BUMDC) in the Department of Periodontology to determine clinical periodontal status and its impact on quality of life among patients visiting dental OPD. A structured and validated Oral Health-Related Quality of Life (OHRQOL) questionnaire was interviewed in local language (Urdu) from the patients. The questionnaire comprised of 14 enquiries based on an individual’s oral health, functional well-being, emotional well-being, expectations and satisfaction with care, and sense of self scored on a Likert scale ranging from 1 (very bad effect) to 5 (very good effect). Dental examination was then conducted under daytime sunlight following standard care for cross control infection and using sterilized examination set and a William’s periodontal probe. The indices used to assess periodontal status were Plaque Index (PI), Loe and Silness, Gingival Index (GI), Clinical Attachment Loss (CAL) and Periodontal Pocket Depth (PPD). Data was entered and analyzed using SPSS version 22. The descriptive of mean and frequency for the variable of socio-demographics were tabulated. Chi square or Fisher exact test was applied to find relationship between periodontal health status and functional, emotional, and social aspects of well-being of life. Whereas logistics regression was applied to find association between dependent (clinical periodontal parameter) and independent variable (socio demographics and other variables from OHRQOL as significant from chi square). The p value of < 0.001 was considered as statistically significant for the study variable. Results: Among the age range of 20-70 years, majority were males 54.4% with 36.3% were between ranges of 26-35 of years. Positive association (p<0.001) was found between age and facial appearance stating that with increasing age the facial supporting structure degenerates leading to a weak muscular organization of supporting tissue. It was found evident that sound and healthy teeth can have a positive effect (p<0.001) on individual disposition and personality based on gender. Considering age, all the four periodontal indices i.e. plaque index, gingival index, clinical attachment loss and periodontal pocket depth were found to be significant (p<0.001, 0.001, 0.001, 0.001) respectively. Affirming that with increasing age and lack of oral hygiene the periodontium health is compromised causing poor impact on individual functional emotional and social aspect of life. It was also found evident that Clinical attachment loss and periodontal pocket depth were associated with gender asserting with increasing age the periodontal ligaments lose its elasticity and firmness (p< 0.001) causing formation of periodontal pockets (p<0.001) and degeneration of periodontal fibers and ligament. Conclusion: To conclude, there is a noteworthy dissimilarity between oral health related QoL in primarily non-regular attendee participants with dissimilar status as judged using OHRQOL. Those with more desirable periodontal conditions i.e., with possible history of periodontal razing were more likely to have a good Qol and quantrariwise. Significant awareness of the dissimilarity in Oral Health that exists between periodontally fit versus periodontally compromised patients over clinical boundaries is significant because it will provide an intuition into the outcome of periodontal complication for patients, daily life and QoL, along with the necessity for addressing these differences.