Periodontal status, perceived stress, diabetes mellitus and oral hygiene care on quality of life: a structural equation modelling analysis

Abstract

Background: To determine if periodontal risk assessment (PRA), the number of missing teeth, diabetes mellitus (DM), perceived stress and interproximal cleaning are associated with oral health-related quality of life (OHRQoL), using Andersen's behavioral modelling (ABM). Material and methods: Data derived from 472 adults derived from a representative population of the Study of Periodontal Health in Almada-Seixal (SoPHiAS) was used. Socioeconomic status, perceived stress scale (PSS-10), oral health behaviors and oral health impact profile (OHIP-14) were collected through questionnaire. Periodontal conditions were assessed with a full-mouth periodontal examination. PRA was computed through behavioral and clinical information. Variables were grouped into Predisposing Factors, Enabling, Need, Oral Health Behaviors and Perceived Health Outcome latent variables. Confirmatory factor analysis, structural ABM and model fitness were conducted. Results: ABM applied to OHIP-14 showed acceptable model fit (χ 2 = 2.75, CFI = 0.92, TLI = 0.90, RMSEA = 0.05, CI 90% [0.04-0.07]). The average of OHRQoL was 9.5 ± 11.3. Patient with periodontitis and with a high number of missing teeth experienced worse OHRQoL. Uncontrolled DM participants had more periodontal treatment necessity and poorer OHRQoL. Characteristic like aging and lower levels of education were directly associated with better OHRQoL, but in indirect path the OHRQoL was diminishes. Good oral hygiene and preventative measures were associated to lower periodontal treatment necessity. Lower periodontal treatment necessity was associated to higher OHRQoL. Age, tooth loss and interproximal cleaning were the most associated items to Predisposing, Need and Oral Health Behaviors, respectively. Conclusion: ABM confirmed age, number of missing teeth, DM, interproximal cleaning and perceived stress as associated factors for OHRQoL. Uncontrolled DM was associated to higher Need and poorer OHRQoL. Good oral hygiene habits promote a healthy periodontium and, consequently, increases OHRQoL.

Periodontal Inflamed Surface Area Is Associated With Increased Gestational Blood Pressure and Uric Acid Levels Among Pregnant Women From Rural North China

“…The major limitations of the current study include the crosssectional design that precludes causal inferences, the small sample size, and possible effects of unaddressed predictors such as nutritional status, lifestyle-related risk factors, genotype, the possibility of occult infection, level of antenatal care level, physical activity, weight gain, sleep, psychological status, among others (16,(55)(56)(57)(58)(59)(60). To compensate in part, a SEM model was thus designed to construct and model unobserved or latent dimensions and has been previously applied in periodontal research (61)(62)(63)(64)(65). Furthermore, this study design fails to address the possible syndemic nature of the association between periodontal inflammation and systemic state, whereby vulnerable subsets may be affected by both periodontal and other inflammatory conditions (66).…”

Blood Pressure and Tooth Loss: A Large Cross-Sectional Study with Age Mediation Analysis

“…Another limitation is the patients’ inability to report, precisely, the cause of tooth loss. Recent studies in this regional area, but also at a national level, have demonstrated the serious ignorance regarding oral health, its consequences and oral hygiene habits [ 63 , 64 , 65 , 66 , 67 , 68 ]. Thus, it would be very risky to consider self-reported data regarding the cause of tooth loss.…”

Early Tooth Loss after Periodontal Diagnosis: Development and Validation of a Clinical Decision Model

“…This model accounts for solely clinical measures and with high reliability performance, hence it may be commissioned in large-based studies to predict tooth loss in the short-term. To the public health view, this conceivable information might be crucial to delineate and prepare appropriate measures to target tooth loss and edentulism, both recognized as disturbing public health problems and with devastating consequences for oral health-related quality of life [2,29,30].…”