Bertl Kristina, Tsakos Georgios, Pandis Nikolaos, Bogren Anna, Burisch Johan, Stavropoulos Andreas
Department of Periodontology, Dental Clinic, Faculty of Medicine, Sigmund Freud University, Vienna, Austria.
Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.
J Clin Periodontol. 2023 Dec;50(12):1601-1620. doi: 10.1111/jcpe.13863. Epub 2023 Sep 5.
To assess whether oral health problems affect disease-specific quality of life (QoL) of inflammatory bowel disease (IBD) patients, and vice versa, whether IBD affects oral-health-related QoL.
Individuals reporting IBD and matched controls were surveyed on general anamnestic information, oral-health-related questions and the Oral Health Impact Profile (OHIP)-5. IBD patients were additionally surveyed on years since diagnosis, disease activity and severity as well as health-related QoL (Short Inflammatory Bowel Disease Questionnaire, sIBDQ). OHIP-5 and sIBDQ were defined as primary outcome parameters, and several predictors and confounders were used in adjusted univariable and multivariable regression analyses.
Answers from 1108 IBD patients and 3429 controls were analysed. Compared with controls, IBD patients reported significantly more frequently an oral impact on daily life and worse oral-health-related QoL, with Crohn's disease (CD) patients being more severely affected than ulcerative colitis (UC) patients. The diagnosis of UC and CD, having <20 teeth, severe periodontitis and stressful daily-life experience were associated with a higher prevalence of poor oral-health-related QoL. Among IBD patients, an impaired IBD-specific, health-related QoL was significantly associated with the diagnosis of CD and depression, IBD activity and severity, having <20 teeth, presence of oral lesions and stressful daily-life experience, while a longer time since diagnosis was significantly associated with an improved IBD-specific, health-related QoL.
The results of the present study indicate, for the first time, that oral health problems are associated with an impairment of IBD-specific health-related QoL, and vice versa, IBD is associated with an impaired oral health-related QoL. This emphasizes the potential advantages of including dental professionals in the multi-disciplinary treatment teams of IBD patients.
评估口腔健康问题是否会影响炎症性肠病(IBD)患者特定疾病的生活质量(QoL),反之,IBD是否会影响口腔健康相关的QoL。
对报告患有IBD的个体及匹配的对照组进行调查,内容包括一般既往史信息、口腔健康相关问题以及口腔健康影响程度量表(OHIP)-5。另外,对IBD患者还调查了确诊后的年数、疾病活动度和严重程度以及健康相关QoL(简短炎症性肠病问卷,sIBDQ)。将OHIP-5和sIBDQ定义为主要结局参数,并在调整后的单变量和多变量回归分析中使用了多个预测因素和混杂因素。
分析了1108例IBD患者和3429例对照组的回答。与对照组相比,IBD患者报告日常生活受到口腔影响的频率明显更高,且口腔健康相关QoL更差,克罗恩病(CD)患者比溃疡性结肠炎(UC)患者受影响更严重。UC和CD的诊断、牙齿少于20颗、重度牙周炎以及紧张的日常生活经历与口腔健康相关QoL较差的患病率较高有关。在IBD患者中,IBD特异性的、与健康相关的QoL受损与CD的诊断、抑郁、IBD活动度和严重程度、牙齿少于20颗、口腔病变的存在以及紧张的日常生活经历显著相关,而确诊后时间较长与IBD特异性的、与健康相关的QoL改善显著相关。
本研究结果首次表明,口腔健康问题与IBD特异性的、与健康相关的QoL受损有关,反之,IBD与口腔健康相关QoL受损有关。这强调了将牙科专业人员纳入IBD患者多学科治疗团队的潜在优势。