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Table of Contents
ORIGINAL ARTICLE
Year : 2021  |  Volume : 8  |  Issue : 4  |  Page : 94-97

Oral health-related quality of life among prosthodontic patients in Telangana, India


Sr. Lecturer, Department of Prosthodontics, Meghna Institute of Dental Sciences, Nizamabad, Telangana, India

Date of Submission07-Nov-2021
Date of Acceptance30-Nov-2021
Date of Web Publication23-Dec-2021

Correspondence Address:
Dr. S Phanindra
Department of Prosthodontics, Meghna Institute of Dental Sciences, Nizamabad - 503 003, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijpcdr.ijpcdr_36_21

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  Abstract 


Objective: The aim of this study was to evaluate factors affecting oral health-related quality of life (OHRQoL) of patients using a removable dental prosthesis.
Methodology: The present study employed a cross-sectional analytical design. A total of 100 patients participated and interviewed using a cross-sectional analytical design. In the first section of the questionnaire, patients were asked about demographic data whereas the second part of the questionnaire assessed medical history, oral habits, smoking status, oral hygiene habits, and frequency of dental visit. The questionnaire also collected information regarding the patient's removable prosthesis. Questionnaire of Oral Health Impact Profile (OHIP-DENT) was also employed to measure oral health QoL (OHRQoL) on the domains of functional limitation (FL), physical pain (P1), psychological discomfort (P2), physical disability (D1), psychological disability (D2), social disability (D3) and handicap (H). Relationships between the demographic, socioeconomic, and education variables and others OHIP-EDENT scores were explored by comparing mean scores by applying ANOVA.
Results: The OHIP-DENT score of participants was calculated for each domain for their mean and standard deviation values. The highest score was recorded for the FL domain (15.82 ± 6.6), followed by social disability (D3) (15.23 ± 5.06) and physical pain (P1) (14.29 ± 4.8). The respective scores for physical disability (D1), psychological disability (D2), and handicap (H) were 10.47 ± 4.84, 11.32 ± 5.38, and 12.45 ± 4.50, respectively. The lowest score was recorded for psychological discomfort (P2) (7.51 ± 4.11).
Conclusion: Removable partial denture patients showed minimum problems with mastication, social compromise, and functional discomfort. The oral health QoL of removable denture patients is significantly influenced by patient education level, socioeconomic status, medical conditions, smoking, and tobacco use habits.

Keywords: Dentistry, oral health quality of life, prosthodontics, removable partial denture


How to cite this article:
Phanindra S. Oral health-related quality of life among prosthodontic patients in Telangana, India. Int J Prev Clin Dent Res 2021;8:94-7

How to cite this URL:
Phanindra S. Oral health-related quality of life among prosthodontic patients in Telangana, India. Int J Prev Clin Dent Res [serial online] 2021 [cited 2022 Jan 20];8:94-7. Available from: https://www.ijpcdr.org/text.asp?2021/8/4/94/333546




  Introduction Top


The quality of life (QoL) is evidently influenced by the individual's ability to participate in daily life activities that in turn may be affected by factors such as social circle, economic status, and stress.[1],[2] Based on the fact that the oral health is associated with socioeconomic and psychological aspects, it is considered as an important component of QoL assessment. The World Health Organization has recognized oral health-related QoL (OHRQoL) an integral part of global oral health programs. In terms of oral health for instance, relatively more number of remaining teeth are observed in the aging population. However, still there are growing population suffering from loss of multiple teeth and the need for removable or fixed dental prosthesis.[3],[4] Having dental prosthesis instead of natural teeth may deteriorate patient's QoL in a number of ways such as possible functional or esthetic compromises, lack of retention or stability and psychological impact. In order to diminish such effects, it is important to assess the factors affecting the OHRQoL. Therefore, the OHRQoL assessment has become a vital tool for patient-oriented dental research. A number of indices and research tools have been used for this purpose such as Geriatric Oral Health Assessment Index[5],[6],[7] Oral Health Impact Profile (OHIP)[8] and various multiple-choice questionnaires. The OHIP is a validated research tool for assessing the OHRQoL[9] and has been used in this study to assess the response of subpopulation.[10] It is hypothesized that factors effecting OHQoL factors for Removable partial denture patients can be identified as an outcome of the study. The aim of this study was to evaluate various factors affecting the OHRQoL of Prosthodontic Patients using a removable dental prosthesis.


  Methodology Top


All procedures performed in the study were conducted in accordance with the ethics standards given in 1964 Declaration of Helsinki, as revised in 2013. The study proposal was submitted for approval and clearance was obtained from the ethical committee of our institution. A written informed consent was obtained from each participant. Our study was conducted from May 2019 to December 2019 after board review at Meghna Institute of Dental Sciences Nizamabad, Telangana, using a cross-sectional analytical design. Patients were recruited from prosthodontics OPD in Meghna Institute of Dental Sciences Nizamabad, Telangana. A sample of 100 participants was considered adequate based on calculations from previous studies.[4],[5] Patients having removable prosthodontic treatment for replacement of missing or lost teeth by prosthodontic specialists were included. A total of 100 patients consented to participate and were interviewed by telephone to identify the patient initially, to confirm previous treatment, and their selection according to inclusion and exclusion criteria. Medically healthy patients who had removable prosthodontic treatment in the past 2 years were included. Patients with life-threatening conditions, physical and psychological ailments, those treated by nonspecialist and patients with a history of malignancy, chemotherapy or radiotherapy in head and neck region were excluded. Patients were assured that all information was strictly confidential.

Questionnaire and data collection

The questionnaires were available in English and Telegu languages. The questionnaire used in this study comprised of two sections; first section assessed the demographic data of the participants. The second section assessed the medical history, oral habits, smoking status, oral hygiene habits, and frequency of dental visit. The questionnaire also collected information regarding prosthesis such as the number of teeth, type of prosthesis (complete or partial), location of prosthesis, duration of function, and number of prosthesis. All patients were evaluated at a review appointment and requested to complete the questionnaires. A second questionnaire of OHIP-DENT[10] was employed to measure oral health QoL (OHRQoL). The main domains assessed in the OHIP-DENT questionnaire were functional limitation (FL), physical pain (P1), psychological discomfort (P2), physical disability (D1), psychological disability (D2), social disability (D3), and handicap (H). The OHIP-DENT questionnaire comprised of 19 items giving the choice of responding in five categories for each item:

  1. Never
  2. Hardly ever
  3. Occasionally
  4. Fairly often
  5. Very often.


In addition, patients were also asked regarding their satisfaction from the prosthesis. Patients responded according to a Likert scale:[11]

  1. Totally satisfied
  2. Very satisfied
  3. Reasonably satisfied
  4. Not very satisfied
  5. Not at all satisfied.


All responses to questions were coded and entered into a spreadsheet by a single operator.

The data analysis and recordings were carried out using the Statistical Package for Social Sciences (SPSS) version 21.0. The means and standard deviations (SDs) for the mean scores for the overall participants were identified using descriptive statistics. The frequency distributions of all responses were computed. Relationships between the demographic, socioeconomic and education variables and others OHIP-EDENT scores were explored by comparing mean scores by applying ANOVA.


  Results Top


A total of 100 subjects were included in the study according to the inclusion criteria. The study participants comprised of 53.5% males and females 46.5% females. Most of the participants (92.5%) belonged to low or middle socioeconomic status, while only 4.5% were from high class. Most of the participants (69%) reported no habit of using tobacco or gutka, while tobacco and pan/gutka were being used by 12.5% and 13.5% of participants, respectively. 66.5% were never-smokers, 11% were previous smokers and 22.5% reported to be smoking currently. In terms of medical conditions, 50.5% reported no significant medical conditions while 49.5% had some kind of systemic illness such as cardiovascular (11%), diabetes (23%), arthritis, GIT and dryness of mouth (7.5%), hepatitis, HIV and muscular disorder (7%). The participant's interest for dental care was assessed by recording dental visit frequency and oral hygiene habits. Percentage of participants reported to visit their dentist within 1, 2–5 years and after 5 years or later was 40.0%, 29.5%, and 30.6%, respectively. Equal numbers of participants were brushing their teeth once or twice a day (32.5%) while the remaining 35% were not regular in brushing their teeth. The participants of this study were using a variety of removable partial dentures (RPD) including RPD in L jaw (27.5%), RPD in U jaw (24.5%), and RPD in both jaws (48%).

Measurement of Domains of Oral Health Impact Profile-EDENT

The OHIP-DENT score of participants was calculated for each domain for their mean and SD values as shown in [Table 1]. The highest score was recorded for the FL domain (15.82 ± 6.6), followed by social disability (D3) (15.23 ± 5.06) and physical pain (P1) (14.29 ± 4.8). The respective scores for physical disability (D1), psychological disability (D2), and handicap (H) were 10.47 ± 4.84, 11.32 ± 5.38, and 12.45 ± 4.50, respectively. The lowest score was recorded for psychological discomfort (P2) (7.51 ± 4.11)
Table 1: Descriptive statistics of scores of different domains of Oral Health Impact Profile-EDENT

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Males recorded higher impact in all domains except psychological discomfort and handicap. A significant relationship was found between gender and psychological (P = 0.020) and social disability (P = 0.040), with the males scoring higher than females. Patients who had no formal schooling or schooling up to standard 5 reported much lower impacts than patients who had secondary or tertiary education. A significant relationship was found between education and FL (P = 0.030) and physical disability (P = 0.040). Patients who were in a higher income group generally reported more OHRQoL impacts than patients who earned a lower salary. Patients who had no source of income recorded the lowest impacts for social disability (mean = 5.4, P = 0.360) and handicap (mean = 6.2, P = 261). A significant relationship was found between economic status and psychological disability (P = 0.01) and psychological discomfort (P = 0.03). Patients with no medical condition reported higher impact scores in all domains. Significant relationships were also found between the physical pain and psychosocial domains with general medical health. Patients who were habitual users of pan, ghutka, and others, generally reported more OHIP-DENT impacts than patients who were not involved in any habits. Significant relationships were found in physical and psychosocial domains. Patients who were smokers reported higher impact scores in all OHIP-DENT domains. Significant relationships were found between FL, physical and psychosocial domains.


  Discussion Top


In this study, the highest OHIP mean values were observed in domains of FL, and social disability. Suggesting that most of participant's difficulties were related to mastication, speech, bad odor, taste and type of food, in addition to communication, social interactions, ill-fitting denture, and inadequate retention. This signifies that participants persevered with great functional difficulty as it was not painful. Most edentulous patients feel helpless and believe that they have to accept denture problems as part of wearing a prosthesis. On the other hand, the OHIP mean scores were the lowest in psychological discomfort. These results are comparable to a recent study by Kranjčić et al.[12] according to which, younger participants, members from rural places, those with lower levels of education, and shorter periods of denture wearing demonstrated a higher impact on OHRQoL. Kranjčić et al. showed that OHRQoL was significantly affected by the participants' age, education, profession, residence place size, type of prosthesis, and the time of denture wearing period. In the present study, significant differences were found between the various domains of OHIP and the patients' gender, education status, general health condition of the patients, and their smoking status. Whereas no significant differences could be found with socioeconomic status, habits of the patients and the type of their prosthesis. Studies have shown that factors such as age, education, profession, type of prosthesis, and the time of denture wearing period significantly affect OHRQoL.[11],[12],[13],[14],[15] However, in our sample of patients, gender and psychological discomfort showed a significant relationship (P = 0.040) with the males, scoring higher than females. Similar results were reported in a previous OHRQoL study on fixed and removable partial dental prostheses. However, age was more significantly associated with OHRQoL than gender in such studies. With regards to clinical implications of the findings, it is the authors' opinion that patient's expectations must be taken into consideration and all possible limitations must be discussed with them before embarking on an extensive removable prosthodontic treatment. A possible limitation of OHQoL studies is the subjective responses of patients which are influenced by patient behavioral and psychological attitude.[16],[17],[18],[19],[20],[21],[22],[23] Clinicians should also recognize the important role they play in improving patient's QoL by assessing factors such as age, education, social status, type of prosthesis, habits, and medical conditions of patients. Therefore, for a successful prosthodontic treatment outcome of removable denture patients, factors effecting oral health and QoL including smoking, tobacco chewing habits, medical conditions, education, and patient motivation must be addressed.


  Conclusion Top


Removable partial denture patients showed minimum problems with mastication, social compromise, and functional discomfort. The oral health QoL of removable denture patients is significantly influenced by patient education level, socio-economic status, medical conditions, smoking, and tobacco use habits.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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