Dental health status and oral health behaviours of patients with facial burn in Pakistan

Abstract

Background There is a limited understanding about the oral health of patients with facial burn, hence the aim was to describe the oral health status and the related risks factors. Methods This cross-sectional study had randomly and systematically recruited facial burn patients from the Burn Care Center, Pakistan Institute of Medical Sciences, Islamabad, from June of 2016 to July of 2017. Intraoral examination recorded the DMFT, CPI and OHI-S. Information on the socio-demographic status, self-perceived oral health, oral health behaviours were collected using a self-administered questionnaire and; the burn characteristics were obtained from the patients’ medical record. The t-test, ANOVA, SLR, and chi-square test were used to examine the relationship between oral health and each factor. A parameter was derived from the clinical indices using the principal component analysis and used in the multiple linear regression analysis to determine the important factors associated with oral health status. Results A total of 271 burn patients (69% female and 31% male) had participated in the study. All of the participants had caries with mean DMFT = 10.96 (95%CI: 10.67, 11.25). There were 59.0% (95%CI: 53.15, 64.93%) and 66.1% (95%CI: 60.38, 71.73%) of the participants who had periodontitis and poor oral hygiene respectively. About 79 and 80% of the participants rated their dental and periodontal status as poor. About 78% reported brushing once daily and 89% did not practice regular dental visit. The DMFT, CPI and OHI-S were associated with the burn characteristics and oral health behaviours ( p < 0.05). Dental anxiety, cost and social issues were the most cited reasons for not utilising oral health services. Greater burn severity, the longer time elapsed since the burn incident, and dental anxiety were associated with poorer oral health status and; brushing twice or more and regular dental visit, with better status ( p < 0.01). Conclusion Patients with oro-facial burn injury had a generally poor oral health and, the risks are greater in those with a more severe and wider area of injury, the longer time elapsed since the burn incident and dental anxiety; but a good oral hygiene practice and regular dental visits were protective against the risk.

The relationship between psychosocial distress and oral health status in patients with facial burns and mediation by oral health behaviour

“…Evidence has also linked these conditions to less frequent tooth brushing and fewer dental visits [11]. Poor oral health outcomes in individuals with facial burns have been linked to dental anxiety [12]. However, there is little discussion on the influence of psychosocial factors on oral health in these patients.…”

Oral health-related quality of life and related factors among facial burn injury patients in Pakistan.

“…Most of the participants avoided the dentist for fear of treatment and feeling embarrassed with their dental conditions. Those with social barriers have problems to interact with other people because they are shy, lack self-confidence or have low esteem (28); which could be due to the dental condition and/or disfigured appearance. Thus, they lose the opportunity to learn about good oral hygiene practice and get the treatment for their condition.…”

“…The results of this study should be interpreted with caution. Several limitations relating to the limited inference from the cross-sectional study design, reference population from a single institution in Pakistan, lack of reliability study due to patients unwilling to return for clinical reassessment and recall bias, have been discussed earlier (28). A very limited inference can be drawn for facial burn patients who are not followed-up at a burn centre.…”

“…Stress, anxiety and depression, which are not uncommon to them, are also risk factors of tooth decay, periodontal disease, and tooth loss (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). Recent evidence suggests that the burden of oral diseases in facial burn patients is high (28) and potentially impact on the oral health-related quality of life, but the evidence is currently a limited. Thus, the current report aims to describe the oral health-related quality of life (OHRQoL) in patients with facial burn injury and examine the associated factors.…”

Barriers to the access of oral health care facilities among adults: an exploratory study from Lahore

“…A local study showed that only 10.7% of the adult population had visited dentists for regular checkups during the last year in Pakistan. 6 Hence, easy access to oral healthcare facilities with affordability and addressing the barriers to this basic human right is of great importance for the overall well-being of the adult population. There is limited availability of public dental healthcare facilities serving oral health care needs as the dentist to population ratio is 1:1305811 in Pakistan.…”