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Dental anxiety and oral health-related quality of life before and after non-surgical periodontal treatment

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Abstract

Objectives

To (1) investigate dental anxiety (DA) and oral health-related quality of life (OHRQOL) before and after non-surgical periodontal treatment (NSPT) and (2) determine correlations between these patient-reported measures.

Materials and methods

Demographics, smoking habits, dental pain, Modified Corah’s Dental Anxiety Scale (MDAS), and Oral Health Impact Profile (OHIP-14) were assessed in eighty-two participants.

Results

Mean age was 48.3 years ± 11.5. At baseline, 8.5% reported being active smokers. Of non-smokers, 11% reported being an ex-smoker. After NSPT, 11.0% reported smoking. Patients’ maximal pain in the last month decreased after therapy. Before treatment, participants reported higher DA. Extreme DA was observed in 8.5% of participants before therapy. Afterwards, 2.4% of participants reported extreme DA. Fear of having a foreign object in the mouth decreased after NSPT. All OHIP-14 scores, except functional limitation, improved post-treatment. Higher DA was associated with worse OHRQoL before treatment. After treatment, total MDAS score was associated with OHIP-14 global score, physical pain, psychological disability, and social disability. Worse MDAS sub-scores were associated with a higher OHIP-14 global score. Individuals with “normal/slight anxiety” had a significant improvement in OHRQoL, whereas people in the “moderate and extreme anxiety” group did not report a significant improvement. Patients diagnosed with generalized periodontitis (GP) stage III grade B and GP stage IV grade B reported less anxiety after NSPT.

Conclusions

Associations of MDAS subcategories with OHIP-14 domain scores were found before and after therapy. DA decreases and OHRQoL enhances after NSPT in patients with “normal/slight” anxiety to dental treatment. Dental practitioners should plan strategies to cope with anxiety to dental treatment and prevent decreases in OHRQoL.

Clinical relevance

Within the limitations of this study, DA and OHRQoL were positively correlated in patients with periodontitis, before and after NSPT, using the MDAS and OHIP-14 questionnaires. The results of our study suggest that treatment is effective in terms of alleviating DA and improving oral health, along with quality of life, in patients that report “normal/slight” anxiety to dental treatment. Nonetheless, results must be interpreted with caution since patients are generally anxious before any type of dental treatment. DA may not just be confined to NSPT per se. According to our results, evaluation of both outcomes should be an integral part of routine periodontal clinical evaluation and periodontal reevaluation of initial therapy. It is important that clinicians learn to identify patients that suffer from anxiety and take time to explain the treatment procedures to the patient, to strive for patient’s emotional well-being before, during, and after dental care services. The use of specific questionnaires for both DA and OHRQoL may be more appropriate to demonstrate the psychological and quality of life differences due to periodontal disease and NSPT.

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Data availability

The data of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

We would like to thank our dental students, nowadays colleagues, Juan Ignacio Alvarado, Johnny Artavia, María Amalia Cruz, Antonio Cubillo, Andrés Fernández, Sofía Quesada, Katherine Redondo, Daniela Sanabria, Dylan Solórzano, José Andrés Torres, Mercedes Vargas, and Mariana Vega, for assistance in the project.

Funding

University of Costa Rica Vice Rector’s Office for Research ordinary funds Project C2323 given to Dr. Karol Ramírez.

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Authors and Affiliations

  1. Faculty of Dentistry, University of Costa Rica, Finca 3 “Instalaciones Deportivas”, Sabanilla, Montes de Oca, San José, 11502, Costa Rica

    Lucía Piedra-Hernández, Adrián Gómez-Fernández & Karol Ramírez

  2. School of Statistics, University of Costa Rica, Rodrigo Facio Campus, San Pedro, Montes de Oca, San José, 11801, Costa Rica

    Daniela Batista-Cárdenas

Authors
  1. Lucía Piedra-Hernández
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  2. Daniela Batista-Cárdenas
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  3. Adrián Gómez-Fernández
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  4. Karol Ramírez
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Contributions

K.R. contributed to the study conception and design. Material preparation and data collection, were performed by K.R., L.P–H., and D.B-C. Analysis of raw data and interpretation was done by K.R. and D.B-C.The first draft of the manuscript was written by K.R. Tables 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10 were prepared by K.R and D.B-C. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Karol Ramírez.

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Ethics approval

The Scientific Ethics Committee of the University of Costa Rica approved all procedures performed in the study (CEC- 341- 2021).

Consent to participate

Written informed consent was obtained from each participant included in the study.

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The authors declare no competing interests.

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Piedra-Hernández, L., Batista-Cárdenas, D., Gómez-Fernández, A. et al. Dental anxiety and oral health-related quality of life before and after non-surgical periodontal treatment. Clin Oral Invest 27, 5459–5474 (2023). https://doi.org/10.1007/s00784-023-05165-1

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  • DOI: https://doi.org/10.1007/s00784-023-05165-1

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