Abstract
To evaluate factors associated with oral health-related quality of life (OHRQoL) in patients under oral anticoagulant therapy with warfarin, a cross-sectional study was conducted. Validated questionnaires assessed self-reported periodontal disease, demographic variables, and OHRQoL using the short version of the Oral Health Impact Profile (OHIP-14) instrument. After calibration (Kappa > 0.60), an examiner evaluated patients’ experience with dental caries and the need for dental prostheses. Statistical analysis involved proportions and measures of central tendency. Negative binomial regression models were used to estimate the rate ratios (RR) and the corresponding 95% confidence interval (CI). The sample consisted of 158 individuals, with a mean age of 58.8 years (SD = 12.1), of which 62.7% of the participants were women. The OHIP-14 mean was 10.62 (SD = 10.92). A higher OHIP-14 total score (worse OHRQoL) was associated with ethnic group, age, periodontal disease self-report, dental caries, and oral health self-report. Demographic and clinical factors can negatively influence the perception of anticoagulated patients on OHRQoL.
Highlights
Regarding the indications for Oral anticoagulant therapy (OAT), the results showed that the majority of patients had some fibrillation (19.7% non-valve atrial fibrillation/flutter and 23.7% valve atrial fibrillation/flutter) or some prosthetic heart valves (4.6% with biological valve prosthesis, 27.0% with mechanical valve prosthesis and 34.2% with mechanical valve prosthesis)
The sum of these diagnoses was higher than 100%, considering that the same patient could have more than one OAT indication
Our study identified that patients using warfarin have factors associated with oral health-related quality of life (OHRQoL), similar to the general population, as shown by a systemic review
Summary
OAT is recommended for outpatients with atrial fibrillation, prosthetic heart valves, venous thromboembolism, acute coronary syndrome or myocardial infarction, and pulmonary hypertension for prevention and treatment, reducing the risk of stroke-related morbidity and mortality [2,4,5,6,7,8]. Coumarin derivatives, such as warfarin, are the most commonly used drugs, especially in low and middle-income countries [6,9,10,11]. Both insufficient and excessive anticoagulation effects can be harmful, increasing thromboembolic and hemorrhagic risks, respectively [2]
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