Description

Title: 3648 - Association Between Periodontal Health/Disease and Patient Reported Outcomes

Authors:

Praveen Sharma (Presenter)
University of Birmingham

Thomas Dietrich, University of Birmingham
Mike Busby, Denplan
Henry Clover, Chief Dental Officer Denplan Ltd
Iain Chapple, University of Birmingham

Abstract:

Objectives: Patient reported outcomes (PROs) allow the patient’s perception of their health/disease to be assessed.
The objective of this study was to explore the association between periodontal health and PROs in a large general dental practice based cohort.

Methods: Data were collected from 14,620 dentate patients by 355 dentists in 233 general dental practices across the UK. The patients were from practices which operate a dental payment plan (Denplan) and data were collected using an online disease risk and oral health assessment tool, DEPPA (Denplan PreViser Patient Assessment’). Clinical data such as periodontal probing depth (PPD), bleeding on probing (BOP), and radiographic on alveolar bone loss were combined to classify patients’ periodontal health (Table_1).
PRO data were collected by asking:
“Are you experiencing any pain or discomfort in your mouth?”
“Do your teeth allow you to eat an unrestricted diet?”
“How do you feel about the appearance of your teeth?”
Logistic regression analysis was used to investigate the associations between PROs and periodontal health status adjusting for age, sex, smoking and diabetes status, number of teeth with restorations, number of teeth needing restorations, oral hygiene, dental attendance, toothwear, sugar intake and salivary flow.

Results: The mean age of the cohort was 55.5 years (SD 15.7), 43% were male, 5.7% had diabetes and 63% were never-smokers.
The periodontal health and PROs in this cohort are summarized (Table_2).
Multivariable logistic regression analysis, revealed a trend in the probability of reporting pain ranging from 13.8% (95% CI 12.4-15.2%) in periodontally healthy patients to 20.7% (95% CI 17.2-24.2%) in patients with previous and current severe periodontitis. Similar trends were seen in reporting of diet restriction and reporting unhappiness with appearance (Table_3).

Conclusions: Analysis of this large dataset from primary care dental practices revealed that current periodontitis, particularly current severe periodontitis is associated with patient reported pain, dietary restriction and poor dental appearance. There was no association with gingivitis or past disease experience.

Image(s):

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Table(s):

Periodontal diagnosis Clinical examination Radiographic examination
Healthy No PPD ≥ 5mm and no BOP
Gingivitis No PPD ≥ 5mm but BOP
Previous periodontitis, current health No PPD ≥ 5mm and no BOP 2-4mm bone loss
Previous periodontitis, current gingivitis No PPD ≥ 5mm but BOP 2-4mm bone loss
Current and previous periodontitis PPD ≥ 5mm but 2-4mm bone loss
Previous severe periodontitis, current health/gingivitis No PPD ≥ 5mm +/- BOP >4mm bone loss
Previous severe periodontitis, current periodontitis PPD ≥ 5mm but >4mm bone loss
Current and previous severe periodontitis PPD≥ 7mm >4mm bone loss
  N %
Periodontal health    
Healthy 2,693 19
Gingivitis 3,081 21
Previous periodontitis, current health 2,330 18
Previous periodontitis, current gingivitis 2,898 20
Current and previous periodontitis 1,225 9
Previous severe periodontitis, current health/gingivitis 911 6
Previous severe periodontitis, current periodontitis 868 6
Current and previous severe periodontitis 532 4
Patient reported outcomes    
Pain 2,186 15
Restricted diet 1,645 11
Unhappiness with appearance 3,814 26
Periodontal diagnosis Oral pain Restricted diet Unhappiness with appearance
Healthy 13.8 (12.4-15.2) 10.8 (9.5- 12.0) 22.2 (20.6- 23.8)
Gingivitis 13.9 (12.7-15.2) 9.7 (8.5- 10.8) 24.5 (23.0- 26.1)
Previous periodontitis, current health 14.9 (13.4-16.4) 9.5 (8.3-10.7) 26.6 (24.8- 28.4)
Previous periodontitis, current gingivitis 15.0 (13.7-16.3) 11.2 (10.1-12.4) 26.0 (24.4- 27.6)
Current and previous periodontitis 17.3 (15.2- 19.3) 12.5 (10.7- 14.3) 27.3 (24.8-29.8)
Previous severe periodontitis, current health/gingivitis 13.7 (11.5-16.0) 12.1 (10.0-14.2) 31.7 (28.6-34.8)
Previous severe periodontitis, current periodontitis 17.7 (15.1- 20.3) 15.5 (13.1- 17.9) 32.5 (29.4- 35.6)
Current and previous severe periodontitis 20.7 (17.2- 24.2) 19.2 (15.9- 22.5) 34.3 (30.3- 38.4)

Student Presenter

This abstract is based on research that was funded entirely or partially by an outside source:
NIHR (DRF-2014-07-109)

Disclosure Statement:
The submitter must disclose the names of the organizations with which any author have a relationship, the nature of the relationship, and the clinical or research area involved. The following is submitted: Mike Busby is associated with Denplan Ltd as a self-employed Advisor with the role of research and development for Denplan Excel (Denplan’s practice certification scheme). Henry Clover is the Chief Dental Officer for Denplan Ltd

I have read the IADR policy on licensing.
Signed by Praveen Sharma

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