The Relationship of Orofacial Pain and Dental Health Status and Oral Health Behaviours in Facial Burn Patients.

Farooq Ahmad Chaudhary,Asma Munir Khan,Bilal Arjumand,Saeed Mustafa,Muhammad Qasim Javed,Basaruddin Ahmad,Shaikh Shoeb Yakub,Federica Galli

doi:10.1155/2021/5512755

Abstract

This study aims to examine the association of orofacial pain and oral health status and oral health behaviours in facial burn patients. The participants in this cross-sectional study were randomly recruited from the Burn Care Center, Institute of Medical Sciences, Islamabad, Pakistan. An intraoral evaluation was carried out to record the DMFT and OHI-S. A self-administered questionnaire was used to collect information on sociodemographic status, brushing frequency, and dental visits. Orofacial pain during mandibular movement was assessed using the Visual Analogue Scale (VAS). Psychological status was assessed using the Generalized Anxiety Disorder Scale and Impact of Events Scale. ANOVA and simple and multiple linear regression tests were used to analyse the data. From the 90 facial burn patients included, the majority were below 34 years of age, female, single or divorced, and unemployed. The mean DMFT was 10.7, and 71% had poor oral hygiene. 56% of the participants had moderate-to-severe anxiety, and 68% had posttraumatic stress disorder. 53% of the participants had moderate-to-severe pain during mouth opening or moving the mandible with a mean score of 41.5. Analyses showed that orofacial pain was associated with less frequent brushing, irregular dental visits, greater DMFT score, and more plaque accumulation (OHI-S). It was also associated with employment status, the severity of a burn, anxiety, and stress. The treatment and management of dental and oral conditions in burn patients need judicious balance in controlling and accurate assessment of the pain and improving psychological problems in burn patients.

Highlights

Burn injuries are an example of the most debilitating physical and traumatic injuries that can potentially lead to severe physical and psychological morbidity and mortality [1]. e prevalence of burn cases is declining in the developed countries, but it remains a public health concern in developing countries [2]
Burn patients go through a long journey towards recovery which lasts for years or decades while enduring acute, healing, and rehabilitation phases [3]. e physical complications and impairments caused by burn injuries depend upon their cause, severity, depth, and location of the burn on the body, treatment, and postburn care [3]. e major focus of burn management includes pain, infection, hypertrophic scarring, wound healing, and psychological trauma [4]
All the participants underwent an intraoral examination by one investigator to record the dental (DMFT) and oral hygiene (OHI-S) status using a standard survey method by the World Health Organization (WHO) [10, 11]. e DMFT is a dental caries severity index that expresses the total number of Decayed (D), Missing (M), and Filled (F) teeth, and the total score is calculated by adding all the individual teeth scores that range from 0 to 32 [10]. e Simplified Oral Hygiene Index (OHIS) is used to record the level of oral hygiene by assessing the debris, stains, and calculus on specific surfaces of six index teeth, with total scores ranging from 0 to 6, the latter representing the worst oral hygiene [11]

Summary

Introduction

Burn injuries are an example of the most debilitating physical and traumatic injuries that can potentially lead to severe physical (scars, deformities, disfigurements, and disabilities) and psychological morbidity (distress, suicidal ideation, anxiety, and posttraumatic stress) and mortality [1]. e prevalence of burn cases is declining in the developed countries, but it remains a public health concern in developing countries [2]. According to the World Health Organization (WHO), approximately 11 million cases of burn injuries, including 180,000 fatalities, occur annually worldwide and 90% of them are in low- and middle-income countries [1]. E major focus of burn management includes pain, infection, hypertrophic scarring, wound healing, and psychological trauma [4]. Apart from the acute posttraumatic pain, the most frequent complaint by patients is the pain caused by mechanical hyperalgesia at the affected burn area. It can lead to paresthesia, dysesthesia, loss of sensibility, and chronic pain and further worsens the psychological impact [5]. Chronic pain is another significant problem and source of

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