Association Between Oral Health Status And Quality Of Life Among Selected South Indian Population
Aathira.C.M1, Arvina Rajasekar2*
1 Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai- 77, India.
2 Senior Lecturer, Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences [SIMATS],
Saveetha University, Chennai- 77, India.
*Corresponding Author
Dr. Arvina Rajasekar,
Senior Lecturer, Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences [SIMATS], Saveetha University, Chennai-
77, India.
Tel: +91 9486442309
E-mail: arvinar.sdc@saveetha.com
Received: September 13, 2021; Accepted: September 22, 2021; Published: September 23, 2021
Citation:Aathira.C.M, Arvina Rajasekar. Association Between Oral Health Status And Quality Of Life Among Selected South Indian Population. Int J Dentistry Oral Sci. 2021;8(9):4579-4582. doi: dx.doi.org/10.19070/2377-8075-21000932
Copyright: Dr. Arvina Rajasekar©2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: Periodontal disease is a major oral health problem, which approximately affects 15–17% of the adult population.
However, the periodontal disease not only affects the supporting structures of the oral cavity, but also has a negative
impact on the oral health-related quality of life.
Aim: the aim of the study was to assess the association between oral health status and quality of life among a selected South
Indian population.
Materials and Methods: The present study was conducted among 150 outpatients who reported to the Department of Periodontics,
Saveetha Dental College and Hospitals, Chennai, India. Based on the periodontal status of the patients, patients were
categorised as follows: Group 1 - Clinically healthy (50 patients); Group 2 - Gingivitis (50 patients); Group 3 - Periodontitis
(50 patients). To measure patient based outcomes, Oral Health Impact Profile-14 (OHIP-14) item questionnaire was used.
The OHIP-14 questionnaire consists of seven divisions and the patients were asked to rate each item on a 5-point scale. The
OHIP-14 score is the sum of responses and ranges from 0 to 56. The data was analyzed using Statistical Package for Social
Sciences (SPSS Software, Version 23.0). The association between oral health status and quality of life was done using Chisquare
test. The level of significance was set at p<0.05.
Results: The association between oral health status and quality of life was done using Chi square test. OHIP-14 questionnaire
score range of 41-56 was predominantly given by 39 patients with periodontitis. 21-40 range of scores were predominantly
given by 15 patients with gingivitis. 0-20 range of scores were predominantly given by 42 individuals with clinically healthy
gingiva. The association between oral health status and quality of life was found to be statistically insignificant with the p value
of 0.00.
Conclusion: The present study suggests that patients with periodontitis presented with poor quality of life when compared
to patients with gingivitis and individuals with clinically healthy gingiva. Hence, oral health status is directly associated with
quality of life.
2.Introduction
3.Materials and Methods
3.Results
4.Discussion
5.Conclusion
5.References
Keywords
Gingivitis; Oral Health; Periodontitis; Quality Of Life; Innovative.
Introduction
Recent advances regarding the pathogenesis, prevention, and
treatment of periodontal disease in recent years, these advances
have not been accompanied by a significant reduction in the
prevalence and severity of periodontal disease [1, 2]. The clinical
parameters used to record data in chronic periodontitis patients
include gingival index, probing periodontal depth and clinical attachment
level and also bad breath and chronic inflammation.
The primary etiology of gingivitis is plaque, but there are several
aggravating [3] factors including habits like smoking, stress,
genetic factors, systemic diseases and hormonal distress [4-12].
Untreated gingivitis will cause periodontitis, which manifests as
increased pocket depth, recession, furcation involvement, mobility,
bone loss[13-17].
Such symptoms existing for a chronic period of time certainly has
a great impact on the quality of life in patient’s lives [18]. Since
the disease does not present with any symptoms at its initial stage,
patients may be unaware of this health condition and ignore the
treatment options [19]. There prevails a misunderstanding that exists
among people about the periodontal disease which they think
affects only the soft and hard tissue components of the oral cavity
but then it also affects the quality of life is the bitter truth that is
not prevalent in individuals [20].
Periodontal disease has currently been found to be coexisting
with health conditions like cardiovascular disease, respiratory
diseases, and diabetes [21-23]. Patients with diabetes and other
comorbid conditions are more prone to suffer from periodontal
disease [24]. Various studies have emerged that focus on the patient
centered outcome of periodontal treatment [25-29]. A better
understanding of the consequences of periodontal disease and its
treatment on patient’s perceptions of how their oral health affects
their daily lives can help to address a patient's needs and concerns
and plan the appropriate treatment [30].
Concern towards the quality of life is growing rapidly. Thousands
of articles are being published every year about this topic [31].
There is a growing positive attribute among dentists that patients'
opinions should be considered in the decision-making process
to provide a more comprehensive evaluation of the value [32].
Needleman et al researched the impact of oral health on quality
of life in a group of periodontal patients. Only few reports have
been reported about the impact of oral health-related quality of
life associated with periodontal health or disease in general [33].
The success of any treatment or study depends on the outcome
or result and so patient centered use holds a significant importance
and is rapidly growing in dentistry. Our team has extensive
knowledge and research experience that has translated into
high quality publications [34-53]. The aim of the study was to
assess the association between oral health status and quality of life
among a selected South Indian population.
Materials and Methods
Study Setting:
The present study was conducted among 150 outpatients who
reported to the Department of Periodontics, Saveetha Dental
College and Hospitals, Chennai, India. The ethical clearance was
obtained from the Institutional Ethical Committee and a written
informed consent was obtained from all the study participants.
The patients were screened for bleeding on probing, clinical attachment
loss and probing depth. Patient who presented with no
bleeding on probing, 1-3 mm pocket depth and no clinical attachment
loss were categorized under clinically healthy gingiva, patients
who presented with bleeding on probing, 1-3mm of pocket
depth with no attachment loss were categorized under gingivitis
and patients with bleeding on probing, pocket depth of more
than 3 mm with attachment loss were classified under periodontitis.
Based on the periodontal status of the patients, patients were
categorised as follows: Group 1 - Clinically healthy (50 patients),
Group 2 - Gingivitis (50 patients), Group 3 - Periodontitis (50
patients).
To measure patient based outcomes, Oral Health Impact Profile-
14 (OHIP-14) item questionnaire was used. The OHIP-14
questionnaire consists of seven divisions and the patients were
asked to rate each item on a 5-point scale coded 0 “never”, 1
“hardly ever”, 2 “occasionally”, 3 “fairly often” and 4 “very often”.
The OHIP-14 score is the sum of responses and ranges
from 0 to 56, higher scores indicating poorer oral health related
quality of life.
Statistical Analysis:
The data was analyzed using Statistical Package for Social Sciences
(SPSS Software, Version 23.0). The association between oral
health status and quality of life was done using Chi-square test.
The level of significance was set at p<0.05.
Results
In the present study, 150 patients were enrolled and they were
divided into three groups based on their oral health status as
clinically healthy, gingivitis and periodontitis (50 patients each).
OHIP-14 scores were recorded for all the study subjects and were
associated with their oral hygiene status.
Among 50 clinically healthy individuals, 42 of them had given
OHIP-14 questionnaire scores within the range of 0-20, 8 of
them had given scores within the range of 21-40. Among 50 patients
with gingivitis, 26 patients had given scores within the range
of 0-20, 15 patients had given scores within the range of 21-40 and 9 patients had given scores within the range of 41-56. Among
50 patients with periodontitis, 4 patients had given scores within
the range of 0-20, 7 patients had given scores within the range of
21-40 and 39 patients had given scores within the range of 41-56.
The association between oral health status and quality of life was
done using Chi square test. OHIP-14 questionnaire score range
of 41-56 was predominantly given by patients with periodontitis.
21-40 range of scores were predominantly given by patients with
gingivitis. 0-20 range of scores were predominantly given by individuals
with clinically healthy gingiva. The association between
oral health status and quality of life was found to be statistically
insignificant with the p value of 0.00. (Figure 1).
Figure 1. Graph representing the association between the OHIP-14 scores and the oral health status of the study participants. X axis represents the oral health status of participants and Y axis represents OHIP-14 questionnaire scores of the participants. Blue colour denotes OHIP-14 scores within the range of 0-20, red colour denotes scores within the range of 21-40 and green colour denotes scores within the range of 41-56. OHIP-14 questionnaire score range of 41-56 was predominantly given by patients with periodontitis. 21-40 range of scores were predominantly given by patients with gingivitis. 0-20 range of scores were predominantly given by individuals with clinically healthy gingiva. The association between oral health status and quality of life was found to be statistically insignificant with the p value of 0.00 (Chi square test).
Discussion
The present study was done to assess the oral health status and
quality of life among the selected South Indian population.
Quality of life is nowadays identified as a valid and vital indicator
of service need and intervention outcomes in public health research
and practice. To improve the quality of life, measures have
been taken and initiated like objective and subjective assessments
which is especially useful for evaluating efforts to prevent disabling
chronic diseases and their consequences on patient’s health
[54-55]. The graph clearly explains the quality of life in periodontitis,
gingivitis and patients with clinically healthy gingiva. With 21
- 40 being the moderate score, it was seen that gingivitis patients
(16%) have scored their quality of life affected to be within the
score 21-40. But with 56 being the highest score, periodontitis patients
have scored their quality of life to be in between a score of
41 and 56. Swollen gums, sore gums, receding gums, loose teeth,
halitosis and toothache were associated with increased impact.
The impact of oral health on quality of life in relation to selfreported
symptoms of periodontal diseases were apparent [56].
Previous study conducted in the Chinese population states that
the impact of oral health on the quality of life of the participants
was 22%, which means the answers were mostly fairly often
or very often. This draws light on the influence of periodontal
disease on routine life and its impact on oral health related quality
of life [57]. Another study which was conducted by K. Goel
et al., showed the comparison between the impact of chronic
periodontal diseases and non-surgical periodontal therapy on oral
health-related quality of life and proved that reported periodontal
diseases or gingivitis tends to influence the quality of life in
such patients. When treated they showed appreciable improvement
which was noted [58]. Shah M et al in his study assessed the
quality of life of the chronic periodontitis patients using OHIP-
14 questionnaire after non-surgical periodontal therapy and stated
that periodontal disease was associated with quality of life [59].
Similar results were obtained in few other studies [60, 61]
A study conducted by Needleman et al focussed to explore the
impact of oral health on quality of life in periodontal patients.
Hence forth, periodontal status was found to be related to the
patient's quality of life [33]. It was also found that certain external
factors like gender and demographics influence the result of the
study. A similar study with such results was found and has been
demonstrated in a study of its association with dental anxiety in
the United Kingdom, accounting for about 18% of the variance
of the total score. A study conducted by K.S.Sam et al., showed
that social class, in terms of educational level, was associated with
the OHIP-14S score while gender was not associated [62].
Our findings are in agreement with the previous studies, as both
the oral health status and patient based outcomes were associated
with each other. Further studies need to be conducted to compare
the quality of life before and after the management of periodontal
diseases.
Conclusion
The present study suggests that patients with periodontitis presented
with poor quality of life when compared to patients with
gingivitis and individuals with clinically healthy gingiva. Hence,
oral health status is directly associated with quality of life.
Acknowledgement
The authors would like to acknowledge the help support rendered
by Saveetha Dental College and Hospitals, Saveetha Institute of
Medical and Technical Sciences, Saveetha University, Chennai.
Source of Funding
The present project was sponsored by
• Saveetha Institute of Medical and Technical Sciences,
• Saveetha Dental College and Hospitals,
• Saveetha University,
• Royal Medicals, Dindigul.
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