Abstract
BackgroundTo 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 methodsData 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.ResultsABM applied to OHIP-14 showed acceptable model fit (χ2 = 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.ConclusionABM 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.
Highlights
Periodontal diseases (PD) are one of the major global public health problems [1]
Uncontrolled diabetes mellitus (DM) was associated to higher Need and poorer oral health-related quality of life (OHRQoL)
We considered as an acceptable model fit if: χ2/degrees of freedom ratio < 3.0; Root Mean Square of Approximation (RMSEA) value < 0.06; Confirmatory Fit Index (CFI) and Tucker Lewis index (TLI) ≥ 0.9; and a Standardized Root Mean Square Residual (SRMR) < 0.08 [52,53,54]
Summary
Periodontal diseases (PD) are one of the major global public health problems [1]. Globally, adult populations suffer from mild to moderate periodontitis, while severe periodontitis prevalence range from 5 to 20% [2,3,4,5,6,7,8,9]. Several risk factors have been implicated in the onset and progression of PD such as age, gender, socioeconomic status, low education levels [12,13,14,15], diabetes mellitus (DM) [16], smoking and oral hygiene habits [17,18,19,20] and psychosocial factors, in particular stress [21, 22]. Thereupon, the impact of PD on oral health-related quality of life (OHRQoL) became an important research matter. 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)
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