Association Between Periodontal Health/Disease and Patient Reported Outcomes

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.