Impact of primary endodontic treatment provided by undergraduate students and endodontic specialists on patients’ quality of life

Abstract

Everyday life of individuals can be significantly influenced by positive and negative changes in oral health status, by symptoms and severity of oral disorders and diseases. The World Health Organization (WHO) proclaims a necessity to measure health and the effects of health care not only on the basis of changes in the frequency and severity of diseases but also by estimation of patients’ well-being assessed with the improvement in their quality of life. The aim of our study was to investigate the impact of primary root canal treatment on the perceived quality of life amongst patients treated by providers with different qualification and experience. Two hundred systemically healthy, mentally fit and legally capable of signing an informed consent patients needing an endodontic care were randomly selected and participated voluntarily in the study conducted in the Department of Conservative Dentistry, Faculty of Dental Medicine, Medical University, Sofia, Bulgaria. The treatment was provided by fourth-year and fifth-year students in the course of their clinical exercises and by five endodontic specialists. The study instrument was the modified Oral Health Impact Profile comprising 17 items which was filled in anonymously by all participants. The interview was carried out before the root canal treatment and two weeks after it was completed by one and the same examiner. The impact of endodontic disease and its treatment was recognized by seven conceptual dimensions: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability and handicap. The responses of the OHIP items were made on a five-point scale ranging from 0 = never, 1 = hardly ever, 2 = occasionally, 3 = fairly often to 4 = very often. The analyses of the results revealed that patients perceived their quality of life impaired because of the irreversible inflammation of the dental pulp. The negative impact of the endodontic disease was similar for the patients treated by students and specialists as the difference between the registered mean impact values at the first appointment was insignificant. Experience and training level influenced the degree of improvement as registered mean impact values were significantly greater in the group treated by endodontic specialists when compared to the one treated by undergraduate students.