Dialysis vintage time has the strongest correlation to psychosocial pattern of oral health-related quality of life – a multicentre cross-sectional study

Abstract

BackgroundAim of this cross-sectional, multicentre study was to investigate associations of dialysis vintage time in haemodialysis (CKD5D) patients with oral health-related quality of life (OHRQoL) and dental and periodontal treatment need.Material and MethodsCKD5D patients were divided into subgroups according to dialysis vintage time in different dialysis centres in Germany. OHRQoL was assessed with oral health impact profile (OHIP-G14). Dental treatment need was classified as presence of carious lesions. Periodontal treatment need was defined as periodontal screening index score (PSI) 3-4.ResultsIn total, 190 participants were divided into the subgroups according to the time on CKD5D: 0 - 2 (n = 29), 3 - 5 (n = 35), 6 - 8 (n = 34), 9 - 12 (n = 29), 13 - 20 (n = 34) and >20 years (n = 29). The overall treatment need in the total cohort was 92% (dental 56%, periodontal 88%) with a total OHIP-G14 sum score of 4.17 [2; 0-5] without a significant correlation. Time on CKD5D was inversely correlated with the OHIP G14 score (p<0.01, R = -0.201). The pattern psychosocial impact was significantly associated with the dialysis duration (p<0.01) and showed a negative correlation to the OHIP-G14 (R = -0.283, Spearman´s rho test p<0.01). For oral function also a negative correlation with OHIP-G14 was detected (Spearman´s rho: -0.183).ConclusionsPatients with a prolonged dialysis vintage time show an improved OHRQoL, which might be mainly caused by the positive development of psychosocial pattern of OHRQoL. The oral health situation of HD patients seems unsatisfying, independently of dialysis vintage time and OHRQoL. Accordingly, an improvement in oral health situation of CKD5D patients is mandatory necessary. Thereby, consideration of psychosocial aspects especially at the beginning of CKD5D therapy and a sensitization regarding oral health issues with increasing vintage time might be recommendable. Key words:Dental care, oral health, oral related quality of life, haemodialysis, chronic kidney disease.

Oral health-related quality of life of patients after heart transplantation and those with heart failure is associated with general health-related quality of life: a cross-sectional study

“…A further similarity to the available literature is the missing association between oral health and OHRQoL for the patients within the current study, which has been repeatedly described and was hypothesized accordingly [8][9][10][11][12][13][14][15]. The nearly unaffected OHRQoL of the HTx and HF patients despite the high prevalence of periodontal treatment need in the current study is conspicuous, especially considering the effects of periodontitis on OHRQoL in generally healthy individuals [27].…”

“…Without further results for patients with HF or organ transplantation, several other German patient groups with chronic systemic diseases might be considered to interpret the current study's findings. For example, patients undergoing chronic haemodialysis showed a slightly better OHIP score (4.17) than the HF and HTx patients in the current study [12]. Furthermore, previous examinations of patients with rheumatoid arthritis (7.3) and ankylosing spondylitis (6.2) showed slightly reduced OHRQoL that were comparable to those of the HF and HTx patients [11,13].…”

“…These previous studies repeatedly show a nearly unaffected or slightly reduced OHRQoL, often irrespective of insufficient oral health situations in these patients [8][9][10][11][12][13]. It was thereby assumed that general disease-related parameters would affect the OHRQoL in these chronical diseased patients more strongly than oral diseases or treatment needs [11,12]. Considering the vulnerability of patients after organ transplantation due to their lifelong immunosuppression [16], this situation could be serious.…”

“…Several studies have investigated OHRQoL and its potential associations with oral diseases in patients with different chronic diseases and conditions, including haemodialysis, rheumatic diseases or solid organ transplantation [8][9][10][11][12][13][14][15]. These previous studies repeatedly show a nearly unaffected or slightly reduced OHRQoL, often irrespective of insufficient oral health situations in these patients [8][9][10][11][12][13]. It was thereby assumed that general disease-related parameters would affect the OHRQoL in these chronical diseased patients more strongly than oral diseases or treatment needs [11,12].…”

“…Considering the vulnerability of patients after organ transplantation due to their lifelong immunosuppression [16], this situation could be serious. Patients might waive regular dental consultations because of the perception that their oral health is unaffected, even though they may clinically require high dental and/or periodontal treatment needs [12]. This could be of high relevance for dental care and the clinical management of patients after heart transplantation.…”