Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, D-37075, Göttingen, Germany.
Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany.
Clin Oral Investig. 2019 Oct;23(10):3895-3903. doi: 10.1007/s00784-019-02820-4. Epub 2019 Feb 1.
This study aimed to assess self- and proxy-rated changes in the oral health-related quality of life (OHRQoL) in adult patients with intellectual disabilities after dental treatment in general anesthesia.
The OHRQoL in 52 adult patients with intellectual and developmental disabilities was assessed prior to dental treatment in general anesthesia (t0), 2 to 3 (t1) and 12 weeks (t2) postoperatively. Therefore, patients and primary cargivers were surveyed using either the 5-item short form of the Oral Health Impact Profile translated into easy language (OHIP-G5-easy, self-rating, n = 27) or the 14-item short form of the Oral Health Impact Profile (OHIP-G14, proxy-rating, n = 51), respectively. OHIP-G5-easy and OHIP-G14 summary scores were statistically analyzed with non-parametric mixed effects models and spearman correlation (p < 0.05). Additionally, the effect of demographic, anamnestic, oral health and treatment factors on QHRQoL or on changes of OHRQoL were analyzed using univariate and multivariate ordinal logistic regressions (p < 0.05).
Self- (t0: 5.8 ± 4.6, t1: 4.3 ± 5.9, t2: 2.0 ± 3.9) and proxy-ratings (t0: 18.8 ± 11.6, t1: 10.1 ± 11.2, t2: 2.7 ± 5.3) revealed a significant improvement of OHRQoL after dental treatment in general anesthesia. Data showed a moderate correlation (p < 0.001, r = 0.43). OHRQoL at baseline was affected by the etiology of cognitive impairment and by the periodontal status (OHIP-G14). Improvement of OHRQoL was associated with the etiology of cognitive impairment (OHIP-G14) and the extent of dental treatment (OHIP-G5-easy).
Self- and proxy-ratings revealed a significant improvement of OHRQoL in patients with intellectual disabilities after dental treatment in general anesthesia.
Assessment of OHRQoL promotes patient-centred care of adults with intellectual disabilities.
本研究旨在评估全麻下牙科治疗后智力障碍成年患者的口腔健康相关生活质量（OHRQoL）自评和他评变化。
在全麻下牙科治疗前（t0）、治疗后 2-3 周（t1）和 12 周（t2），使用简易版口腔健康影响量表 5 项简表（OHIP-G5-easy，自评，n=27）和口腔健康影响量表 14 项简表（OHIP-G14，他评，n=51）分别对 52 例智力和发育障碍成年患者的 OHRQoL 进行评估。采用非参数混合效应模型和 Spearman 相关分析对 OHIP-G5-easy 和 OHIP-G14 总分进行统计学分析（p＜0.05）。此外，还采用单变量和多变量有序逻辑回归分析人口统计学、病史、口腔健康和治疗因素对 QHRQoL 或 OHRQoL 变化的影响（p＜0.05）。
自评（t0：5.8±4.6，t1：4.3±5.9，t2：2.0±3.9）和他评（t0：18.8±11.6，t1：10.1±11.2，t2：2.7±5.3）结果均显示全麻下牙科治疗后 OHRQoL 显著改善。数据显示两者中度相关（p＜0.001，r=0.43）。基线 OHRQoL 受认知障碍病因和牙周状况（OHIP-G14）影响。OHRQoL 的改善与认知障碍病因（OHIP-G14）和牙齿治疗范围（OHIP-G5-easy）有关。
全麻下牙科治疗后，智力障碍患者的自评和他评均显示 OHRQoL 显著改善。
评估 OHRQoL 可促进以患者为中心的智力障碍成年人护理。
