Changes in the oral health-related quality of life in adult patients with intellectual disabilities after dental treatment under general anesthesia

  • Anna-Lena Hillebrecht
  • Valentina Hrasky
  • Christoph Anten
  • Annette WiegandEmail author
Original Article



This study aimed to assess self- and proxy-rated changes in the oral health-related quality of life (OHRQoL) in adult patients with intellectual disabilities after dental treatment in general anesthesia.


The OHRQoL in 52 adult patients with intellectual and developmental disabilities was assessed prior to dental treatment in general anesthesia (t0), 2 to 3 (t1) and 12 weeks (t2) postoperatively. Therefore, patients and primary cargivers were surveyed using either the 5-item short form of the Oral Health Impact Profile translated into easy language (OHIP-G5-easy, self-rating, n = 27) or the 14-item short form of the Oral Health Impact Profile (OHIP-G14, proxy-rating, n = 51), respectively. OHIP-G5-easy and OHIP-G14 summary scores were statistically analyzed with non-parametric mixed effects models and spearman correlation (p < 0.05). Additionally, the effect of demographic, anamnestic, oral health and treatment factors on QHRQoL or on changes of OHRQoL were analyzed using univariate and multivariate ordinal logistic regressions (p < 0.05).


Self- (t0: 5.8 ± 4.6, t1: 4.3 ± 5.9, t2: 2.0 ± 3.9) and proxy-ratings (t0: 18.8 ± 11.6, t1: 10.1 ± 11.2, t2: 2.7 ± 5.3) revealed a significant improvement of OHRQoL after dental treatment in general anesthesia. Data showed a moderate correlation (p < 0.001, rSp = 0.43). OHRQoL at baseline was affected by the etiology of cognitive impairment and by the periodontal status (OHIP-G14). Improvement of OHRQoL was associated with the etiology of cognitive impairment (OHIP-G14) and the extent of dental treatment (OHIP-G5-easy).


Self- and proxy-ratings revealed a significant improvement of OHRQoL in patients with intellectual disabilities after dental treatment in general anesthesia.

Clinical relevance

Assessment of OHRQoL promotes patient-centred care of adults with intellectual disabilities.


Oral-health related quality of life Intellectual disabilities Oral health impact profile Dental treatment General anesthesia 



This study was funded by the institutions of the authors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was reviewed and approved by the local ethics committee (No.11/1/16).

Informed consent

Written informed consent was obtained from the legal guardians of the patients.


  1. 1.
    Anders PL, Davis EL (2010) Oral health of patients with intellectual disabilities: a systematic review. Spec Care Dentist 30:110–117. CrossRefGoogle Scholar
  2. 2.
    Mallineni SK, Yiu CKY (2016) Dental treatment under general anesthesia for special-needs patients: analysis of the literature. J Investig Clin Dent 7:325–331. CrossRefGoogle Scholar
  3. 3.
    Chang J, Kim HY (2017) Prognostic factors of single-visit endodontic and restorative treatment under general anaesthesia for special needs patients. J Oral Rehabil 44:96–104. CrossRefGoogle Scholar
  4. 4.
    Alsaleh I, Cousson PY, Nicolas E, Hennequin M (2012) Is endodontic treatment performed under general anaesthesia technically acceptable? Clin Oral Investig 16:1599–1160. CrossRefGoogle Scholar
  5. 5.
    Mallineni SK, Yiu CKY (2014) A retrospective review of outcomes of dental treatment performed for special needs patients under general Anaesthesia: 2-year follow-up. Sci World J 2014:1–6. CrossRefGoogle Scholar
  6. 6.
    Limeres Posse J, Lopez Jimenez J, Ruiz Villandiego JC, Cutando Soriano A, Fernandez Feijoo J, Linazasoro Elorza M, Diniz Frietas M, Diz Dios P (2016) Survival of dental implants in patients with down syndrome: a case series. J Prosthet Dent 116:880–884. CrossRefGoogle Scholar
  7. 7.
    Couto P, Pereira PA, Nunes M, Mendes RA (2018) Oral health-related quality of life of Portuguese adults with mild intellectual disabilities. PLoS One 13:e0193953. CrossRefGoogle Scholar
  8. 8.
    Alves NS, Gavina VP, Cortellazzi KL, Antunes LAA, Silveira FM, Assaf AV (2016) Analysis of clinical, demographic, socioeconomic, and psychosocial determinants of quality of life of persons with intellectual disability: a cross-sectional study: determinants on quality of life of disabled persons. Spec Care Dentist 36:307–314. CrossRefGoogle Scholar
  9. 9.
    Amaral Loureiro AC, Oliveira Costa F, Eustaquio da Costa J (2007) The impact of periodontal disease on the quality of life of individuals with down syndrome. Downs Syndr Res Pract 12:50–54. CrossRefGoogle Scholar
  10. 10.
    Chang J, Patton LL, Kim HY (2014) Impact of dental treatment under general anesthesia on the oral health-related quality of life of adolescents and adults with special needs. Eur J Oral Sci 122:363–371. CrossRefGoogle Scholar
  11. 11.
    Barbosa T, Gavião M (2008) Oral health-related quality of life in children: part III. Is there agreement between parents in rating their children’s oral health-related quality of life? A systematic review. Int J Dent Hyg 6:108–113. CrossRefGoogle Scholar
  12. 12.
    Meyle J, Jepsen S (2000) The periodontal screening-index (PSI). Parodontologie 11:17–21Google Scholar
  13. 13.
    World Health Organisation (2013) Oral health surveys: basic methods, 5th edn. GenfGoogle Scholar
  14. 14.
    Eichner K (1955) Über eine Gruppeneinteilung der Lückengebisse für die Prothetik. Dtsch Zahnärztl Z 10:1831–1834Google Scholar
  15. 15.
    John MT, Miglioretti DL, LeResche L, Koepsell TD, Hujoel P, Micheelis W (2006) German short forms of the Oral health impact profile. Community Dent Oral Epidemiol 34:277–288. CrossRefGoogle Scholar
  16. 16.
    John MT, Micheelis W, Biffar R (2004) Norming of abbreviated versions of the German Oral health impact profile. Schweiz Monatsschr Zahnmed 114:784–791Google Scholar
  17. 17.
    Reissmann DR, Krautz M, Schierz O et al (2008) Was ist klinisch relevant bei Veränderungen der Mundgesundheit? Dtsch Zahnärztl Z 63:669–680Google Scholar
  18. 18.
    John M, Micheelis W, Biffar R (2004) Demographic factors, denture status and Oral health-related quality of life – validation of a short form of the Oral health impact profile (OHIP-G14). Dtsch Zahnärztl Z 59:328–333Google Scholar
  19. 19.
    Rolstad S, Adler J, Rydén A (2011) Response burden and questionnaire length: is shorter better? A review and meta-analysis. Value Health 14:1101–1108. CrossRefGoogle Scholar
  20. 20.
    Robertson S, Cooper C, Hoe J, Hamilton O, Stringer A, Livingston G (2017) Proxy rated quality of life of care home residents with dementia: a systematic review. Int Psychogeriatr 29:569–581. CrossRefGoogle Scholar
  21. 21.
    Clare L, Quinn C, Hoare Z, Whitaker R, Woods RT (2014) Care staff and family member perspectives on quality of life in people with very severe dementia in long-term care: a cross-sectional study. Health Qual Life Outcomes 12:175. CrossRefGoogle Scholar
  22. 22.
    Eiser C, Morse R (2001) Can parents rate their child’s health-related quality of life? Results of a systematic review. Qual Life Res 10:347–357CrossRefGoogle Scholar
  23. 23.
    Schulte AG, Freyer K, Bissar A (2013) Caries experience and treatment need in adults with intellectual disabilities in two German regions. Community Dent Health 30:39–44. Google Scholar
  24. 24.
    Ferreira MC, Dias-Pereira AC, Branco-de-Almeida LS, Martins CC, Paiva SM (2017) Impact of periodontal disease on quality of life: a systematic review. J Periodontal Res 52:651–666. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Preventive Dentistry, Periodontology and CariologyUniversity Medical Center GöttingenGöttingenGermany
  2. 2.Department of Medical StatisticsUniversity Medical Center GöttingenGöttingenGermany

Personalised recommendations