Periodontal Treatment, Individual, Psychological Factors and Oral Health Related Quality of Life

Introduction: Periodontitis negatively impacts on Oral Health Related Quality of Life (OHRQoL) and is ameliorated by periodontal treatment. Individual and environmental factors may affect treatment outcomes. Aim: To determine OHRQoL and clinical changes after the diagnosis and treatment of chronic periodontitis. Objectives: To determine: (1) OHRQoL and clinical changes after periodontal treatment. (2) OHRQoL trajectory from diagnosis to treatment and follow-up. (3) Individual (psychological) and environmental factors predicting OHRQoL and clinical changes after periodontal treatment. (4) Relationships between psychological factors, OHRQoL and clinical changes. Methods: 140 patients with chronic periodontitis completed a prospective single arm intervention study (non-surgical treatment). Participants self-completed questionnaires: Sense of Coherence, Locus of Control, Self-esteem and Task-specific Self-efficacy before treatment, and Oral Health Impact Profile (OHIP-14) at assessment, treatment, oral hygiene review and end of study time points. Relationships between OHRQoL, clinical data, individual and environmental characteristics were explored within the Wilson and Cleary model with structural equation modelling (SEM) and Growth Curve Modelling (GCM). Results: OHRQoL worsened before treatment, then improved along with the periodontal status afterwards. Greater sense of coherence and age, better periodontal status, lower DMFT and being male predicted better OHRQoL after treatment. Better task-specific self-efficacy predicted better baseline and end periodontal status. Greater age and higher plaque score predicted worse baseline periodontal status. Better self-esteem, but worse plaque score predicted better end periodontal status. GCM determined better sense of coherence, being male and a non-smoker predicted better OHRQoL at assessment. The rate of change was predicted by sense of coherence and locus of control. Gains in the clinical attachment level and reductions in probing depths were negatively predicted by task-specific self-efficacy. Conclusions: OHRQoL and the periodontal status improved after periodontal treatment, and this was predicted by individual demographic and psychological factors.