The Journal of the American Dental Association
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J Am Dent Assoc, Vol 140, No 10, 1283-1293.
© 2009 American Dental Association

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RESEARCH

Oral Health–Related Quality of Life and Periodontal Health Status in Patients Undergoing Hemodialysis



Esra Guzeldemir, DDS, PhD, Hilal Uslu Toygar, DDS, PhD, Bahar Tasdelen, MD and Dilek Torun, MD

Background. Health-related quality of life (HRQOL) is a multidimensional concept regarding quality of life (QOL) as it relates specifically to health and disease. The effect of ongoing hemodialysis on a person’s oral health can be determined by clinical variables, but these do not reflect the person’s perception of health versus illness. The authors conducted a study to determine the periodontal status, attitude toward oral health and self-perceived oral health in patients undergoing hemodialysis, as well as to evaluate the effect of oral health on QOL within this group.

Methods. Patients undergoing hemodialysis were evaluated for socio-demographic and periodontal variables. The authors evaluated oral health–related quality of life (OHRQOL) by means of the short-form Oral Health Impact Profile (OHIP-14) and the General Oral Health Assessment Index (GOHAI). They measured perceived oral health by asking a single question.

Results. The study involved 47 patients undergoing hemodialysis. Plaque index score, gingival index score, probing depth and bleeding-on-probing status were 2.21 ± 0.66, 1.24 ± 0.77, 2.17 millimeters ± 0.53 mm and 33.51 percent ± 24.58 percent, respectively. Participants reported being uncomfortable when eating or swallowing. Participants reported being sensitive to hot or cold (69.8 percent), having a worse sense of taste (90.8 percent) and having painful aching in the mouth (72.1 percent). The mean OHIP-14 and GOHAI scores were 19.40 ± 7.74 and 15.72 ± 8.68, respectively.

Conclusions. The self-perceived health of 72.7 percent of participants undergoing hemodialysis was fair or poor, and the impact of OHRQOL was moderate, which means that oral health was not a major concern. These results underscore the importance of using subjective and self-reported oral assessments to determine more convenient and satisfying treatment approaches for each patient.

Clinical Implications. Clinicians should use oral health assessment tools to determine individual treatment and approaches to promote the oral health of patients undergoing hemodialysis and improve their QOL.

Key Words: Chronic renal failure; hemodialysis; periodontal diseases; oral health; dental health; quality of life

Abbreviations: ADD: Additive • BMI: Body mass index • BOP: Bleeding on probing • CRF: Chronic renal failure • ESRD: End-stage renal disease • GFR: Glomerular filtration rate • GI: Gingival index • GOHAI: General Oral Health Assessment Index • HD: Hemodialysis • HRQOL: Health-related quality of life • OHIP: Oral Health Impact Profile • OHIP-14: Oral Health Impact Profile (shortened 14-item version) • OHIP-49: Oral Health Impact Profile • OHRQOL: Oral health–related quality of life • PD: Probing depth • PI: Plaque index • QOL: Quality of life • SC: Simple count • sCr: Serum creatinine







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