Oral Health-related Quality Of Life And Self-reported Anxiety And Depression In Systemic Sclerosis Compared With The UK General Population

Ismail Abdouh, Stephen Porter, Stefano Fedele, Nadia Elgendy, Khalid Aboalshamat, Hamzah Ali Babkair, Richeal Ni Riordain

Introduction:

• Systemic sclerosis (SSc) is a rare chronic multi-systemic disease that commonly affects the skin and other internal organs (Baron,Hudsonetal.2014).

• Orofacial manifestations of SSc occur in about 80-90% of patients and may limit functional and adversely impact upon aesthetics leading to a negative effect on a patient’s emotional and social life (Kwakkenbos, Delisle et al. 2015).

• The disease features of SSc (e.g., fibrosis of the facial skin, microstomia, salivary gland dysfunction and xerostomia, dysphagia and manual dexterity) have the potential to compromise the oral tissue, limit the ability to maintain a good standard of oral hygiene and perhaps increased the risk of caries, periodontal disease (Jung et al., 2016, Smirani et al., 2018).

• A high level of physical and psychological complications (e.g., pain, fatigue, depression, anxiety and fear) can arise in patients with SSc (Ingegnoli, Ughi et al. 2018).

Objectives: To identify the impact of SSc upon oral health-related quality of life (OHRQoL) of patients in the UK.

Methods:

• Study Design: Observational cross-sectional study including questionnaires regarding health and medical condition (OHIP-14, MHISS, HADS, MDAS and OIDP).

• Study Sample: The study group comprised of 50 patients with SSc and 18 controls.

• Study Location: Patients with SSc registered in Scleroderma Society and attending the Rheumatology outpatient clinic at the Royal Free Hospital-London.

• Inclusion Criteria: Individuals aged 18 years and over with a diagnosis of SScwho live in the UK and can understand spoken and written English Language.

• Control Group: The partners or relatives of the individuals with SSc willing to complete the questionnaire.

Table 1. Comparison by OHRQoL measures between patients and controls Table 2. Anxiety and depression measures between patients and controls

Conclusions:• Overall OHRQoL is significantly reduced in SSc compared with general

population, and independently associated with global health-related QoL.

• The impact of SSc upon the OHRQoL could be due to associated orofacial features, a dentist’s lack of experience in dealing with SSc and patient’s own reluctance to attend dental service due to associated co-morbidity of the disease.

• The frequency of reported disease features such as microstomia and tightness of facial skin/oral mucosa might have a significant impact upon patients’ ability to maintain good oral hygiene and access to dental care services.

• Appropriate education on managing disease features, coping with associated disease morbidity and better evaluation of oral health-related disability can be significantly lessen the burden of oral manifestation in SSc.

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sclerosis: a challenging management. Oral Dis.• INGEGNOLI, F., UGHI, N. & MIHAI, C. 2018. Update on the epidemiology, risk factors, and disease outcomes of systemic

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