A Study On Oral Health-related Quality Of Life And Its Associated Factors Among Patients With Periodontitis

ObjectiveThis study aimed to describe the score of Oral Health-Related Quality of Life(OHRQoL)among patients with periodontitis,and to identify the associated factors of OHRQoL among patients with periodontitis based on the model of Health-Related Quality of Life,in order to provide new ideas for dental staff to improve OHRQoL of patients with periodontitis.MethodsThe subjects of the study were selected from the periodontology department of a tertiary stomatological specialist hospital in Shandong province from January 2022 to July 2022.The General Information Questionnaire,The Chinese version of the Oral Health Impact Profile-14(OHIP-14),Emotion Regulation Questionnaire(ERQ),Perceived Stress Scale-4,PSS-10(PSS-10),Self-Efficacy Scale for Self-care(SESS),Family APGAR Index(FAI)and Perceived Social Support Scale(PSSS)were used for assessing general information,OHRQoL,emotion regulation skills,anxiety symptoms,depressive symptoms,perceived stress,SESS,family function and perceived social support.The disease-related data was collected by consulting electronic cases.SPSS 26.0 and R4.2.0 were used for statistical analysis,including descriptive statistics,the Boruta algorithm,multivariate linear regression,and random forest regression analyses.Results1.The OHRQoL score of 459 patients with periodontitis ranged from 0 to 34,with a mean score of 12.56±8.44.Specifically,the median and interquartile range of the impaired independent ability dimension was 1(0,5),the mean score of the psychological discomfort dimension was 3.59±2.62,the median and interquartile range of the physical discomfort dimension was 3(1,5),and the mean score of the pain and discomfort dimension was 3.56± 2.18.2.The OHRQoL and its four dimensions scores of patients with periodontitis were used as the dependent variables,and the variables that were selected by the Boruta algorithm were used as independent variables for multivariate linear regression.The results showed that:(1)Self-reported poor health(β=0.126,P=0.006),periodontitis stage II(β=0.192,P=0.018),periodontitis stage Ⅲ/Ⅳ(β=0.427,P<0.001),dental caries(β=0.134,P=0.003),anxiety symptoms(β=0.105,P=0.028),and perceived stress(β=0.131,P=0.009)were positively correlated with OHRQoL among patients with periodontitis.(2)Self-reported poor health(β=0.112,P=0.016),periodontitis stage Ⅲ/Ⅳ(β=0.319,P=0.001),had missing teeth(β=0.134,P=0.003),anxiety symptoms(β=0.115,P=0.019),and perceived stress(β=0.147,P=0.004)were positively correlated with the impaired independent ability among patients with periodontitis.(3)Self-reported poor health(β=0.142,P=0.002),periodontitis stage Ⅱ(β=0.174,P=0.036),periodontitis stage Ⅲ/Ⅳ(β=0.297,P=0.003),and perceived stress(β=0.160,P=0.002)were positively correlated with psychological discomfort among patients with periodontitis,while did not enter the supportive periodontal treatment(β=-0.161,P=0.008)was negatively related with psychological discomfort in patients with periodontitis.(4)Self-reported poor health(β=0.112,P=0.016),periodontitis stage Ⅱ(β=0.181,P=0.027),periodontitis stage Ⅲ/Ⅳ(β=0.409,P<0.001),dental caries(β=0.142,P=0.002),and perceived stress(β=0.101,P=0.047)were positively correlated with physical discomfort among patients with periodontitis.(5)Periodontitis stage Ⅱ(β=0.225,P=0.007),periodontitis stage Ⅲ/Ⅳ(β=0.403,P<0.001),dental caries(β=0.1220,P<0.001),and low oral health care self-efficacy(β=0.131,P=0.015)were positively correlated with pain and discomfort among patients with periodontitis.3.The results of random forest regression showed that the importance for associated factors of OHRQoL and its four dimensions in periodontitis patients were ranked as follows:(1)The associated factors of OHRQoL among patients with periodontitis were ranked in order of importance from high to low:perceived stress,periodontitis stage Ⅲ/Ⅳ,selfreported poor health,dental caries and anxiety symptoms.(2)The associated factors of the impaired independent ability among patients with periodontitis were ranked in order of importance from high to low:perceived stress,periodontitis stage Ⅲ/Ⅳ,anxiety symptoms,missing teeth and self-reported poor health.(3)The associated factors of psychological discomfort among patients with periodontitis were ranked in order of importance from high to low:perceived stress,self-reported poor health,did not enter the supportive periodontal treatment and periodontitis stage Ⅲ/Ⅳ.(4)The associated factors of physical discomfort among patients with periodontitis were ranked in order of importance from high to low:perceived stress,periodontitis stage III/IV,self-reported poor health and periodontitis stage Ⅱ.(5)The associated factors of pain and discomfort among patients with periodontitis were ranked in order of importance from high to low:periodontitis stage III/IV,dental caries,periodontitis stage II and low oral health care self-efficacy.Conclusions1.The lower OHRQoL scores among patients with periodontitis deserve more attention.2.Perceived stress,periodontitis stage Ⅲ/Ⅳ and self-reported poor health status are significant and important associated factors of OHRQoL among patients with periodontitis which may be the core targets for dental staff to carry out targeted intervention on OHRQoL among patients with periodontitis.In addition,dental caries,missing teeth,did not enter periodontal support treatment,self-reported anxiety symptoms and low oral health selfefficacy have certain effects on OHRQoL among patients with periodontitis.