Oral-Health-Related Quality of Life in Adult Patients with Rheumatic Diseases—A Systematic Review

Abstract

Objectives: The aim of this systematic review was to assess the oral-health-related quality of life (OHRQoL) of adult patients with rheumatic diseases. Material and Methods: A systematic literature search was performed, including clinical studies on adults (aged at least 18 years) with a verified diagnosis of rheumatic disease. Results: 26 out of 41 clinical studies including rheumatoid arthritis (RA, seven studies), systemic sclerosis (SSc, five), Sjögren syndrome (SS, eight), Behcet disease (BD, four), systemic lupus erythematosus (SLE, one) and ankylosing spondylitis (AS, one) were found. In 15 studies, a healthy control group was recruited. The short form of the Oral Health Impact Profile (OHIP 14) was most frequently applied. The majority of studies (14/15) reported worse OHRQoL in patients with rheumatic disease compared to healthy individuals. In particular, patients with SS (salivary flow and composition) or BD (oral ulcers) showed a relation between OHRQoL and disease-specific oral manifestations. Most studies investigating subscales of OHRQoL (5/6) found the subscale physical disability to be predominantly affected in patients with rheumatic diseases. About half of the studies reported impaired psychosocial aspects. Conclusion: Patients with rheumatic diseases exhibit reduced OHRQoL, especially in diseases with oral manifestations like SS and BD. Physical affections due to oral diseases and psychosocial impairments caused by disease-related parameters must be recognized within patient-centered dental care.

Oral Health-Related Quality of Life in Patients With Chronic Respiratory Diseases—Results of a Systematic Review

“…Patients with severe chronic diseases or conditions, e.g., rheumatic diseases or hemodialysis show a reduced OHRQoL caused by their general disease burden including pain and impact on their daily life (15,28). Thereby, the OHIP-14 values for patients with respiratory diseases in this study were similar as for rheumatic diseased patients or individuals undergoing renal replacement therapy (15,28). Thus, the HRQoL impairment due to the general disease could be one reason for the reduced OHRQoL in this study; especially, severely diseased individuals with proceeded COPD, cystic fibrosis, and severe asthma are impaired in their everyday life and show affected HRQoL (29)(30)(31).…”

“…It is known that oral health can affect general HRQoL ( 26 ) and that reduced HRQoL can negatively affect OHRQoL ( 13 , 27 ). Patients with severe chronic diseases or conditions, e.g., rheumatic diseases or hemodialysis show a reduced OHRQoL caused by their general disease burden including pain and impact on their daily life ( 15 , 28 ). Thereby, the OHIP-14 values for patients with respiratory diseases in this study were similar as for rheumatic diseased patients or individuals undergoing renal replacement therapy ( 15 , 28 ).…”

“…In other groups of systemically diseased patients, the OHRQoL showed interesting and clinically relevant results. For example, patients with rheumatic diseases show an impaired OHRQoL, whereby rheumatic disease-related parameters might be major influential factors ( 15 ). On the other hand, patients after solid organ transplantation were supposed to undergo a “response shift” of the perception of OHRQoL, i.e., reduced awareness of their insufficient oral health status ( 16 ).…”

Systemic sclerosis: Update for oral health care providers

“…SSc is associated with significant morbidity with variable outcomes 4 . A systematic review to assess the oral‐health‐related quality of life (OHRQoL) of adult patients with rheumatic diseases concluded that rheumatic diseases with oral involvement, such as SSc, has lower OHRQoL due to oral and psychosocial impairments compared to other rheumatic diseases 5 . A web‐based survey by Leader et al (2014) suggested approximately 50% of dentists ( n = 269) felt they might cause harm to SSc patients because of their insufficient knowledge of the disease 6 .…”

Special Issue “Oral Health and Systemic Diseases”

“…Moreover, the authors hypothesized a shared pathophysiology between the two diseases, based on a local and systemic proinflammatory environment and related oxidative stress. Finally, the third systematic review performed by Schmalz et al [ 15 ] evaluated the oral health-related quality of life in adults with different systemic rheumatic diseases. Thereby, 26 studies with six different rheumatic entities were included.…”