The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 22 , ISSUE 2 ( February, 2021 ) > List of Articles


Assessment of the Effects of Occluding Pairs of Teeth on Oral Health-related Quality of Life among Dialysis Patients

Payal Kahar, Carol A Chapman, Sachi Brahmbhatt, Deepesh Khanna

Keywords : Dental health surveys, Dental prosthesis, Dialysis, Oral health, Quality of life, Tooth loss

Citation Information : Kahar P, Chapman CA, Brahmbhatt S, Khanna D. Assessment of the Effects of Occluding Pairs of Teeth on Oral Health-related Quality of Life among Dialysis Patients. J Contemp Dent Pract 2021; 22 (2):156-161.

DOI: 10.5005/jp-journals-10024-3046

License: CC BY-NC 4.0

Published Online: 17-12-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Aim: To determine oral health-related quality of life (OHRQoL) in hemodialysis patients and assess if location and distribution of teeth had perceived oral impacts. Materials and methods: Face-to-face interviews and oral examinations were conducted among 96 patients in southwest Florida. Sociodemographic data in addition to self-reported medical conditions were collected. OHRQoL was determined using the Geriatric Oral Health Assessment Index (GOHAI-12). Presence of decayed teeth, missing teeth, anterior occluding pairs (AOPs) and posterior occluding pairs (POPs), and community periodontal index were ascertained through oral examinations. Results: Mean age was 64.81 ± 12.9 years. Mean number of teeth present was 20.12 ± 10.8. Nearly half (48%) of the participants had ≥1 decayed teeth. Among those examined for periodontal health, 86% had some form of periodontal disease. Mean AOP was 4.4 ± 2.3 and mean POP was 4.2 ± 3.1. Median GOHAI-12 score was 52. Limiting the kinds or amounts of food (p = 0.040), trouble biting or chewing (p = 0.010), feeling uncomfortable eating in front of people (p = 0.024), and pleased with looks (p = 0.038) were statistically significant for AOP groups. Only trouble biting or chewing (p = 0.044) and pleased with looks showed significant association with POP groups (p = 0.038). In adjusted regression analyses, participants with AOPs 0 to 2 had 86% lower odds of reporting GOHAI-12 scores above 40 (25th percentile) than the group with AOPs 3 to 6 (odds ratio = 0.14; 95% confidence interval = 0.04–0.58). Conclusion: The study highlights fewer AOP to have a larger effect than POP not only in the psychosocial dimension but also in the functional abilities. Lower GOHAI-12 scores were associated with AOP 2 or less than 2 in the study sample. Clinical significance: While treatment and management of oral health problems in dialysis patients are complicated by the presence of co-morbidities, age-related changes in the mouth, and issues of access to dental care, identification, repair, or replacement of strategically important teeth using the “shortened dental arch principle” to maintain oral function among hemodialysis patients are recommended.

  1. Petersen PE, Yamamoto T. Improving the oral health of older people: the approach of the WHO global oral health programme. Community Dent Oral Epidemiol 2005;33(2):81–92. DOI: 10.1111/j.1600-0528.2004.00219.x.
  2. Naugle K, Darby ML, Bauman DB, et al. The oral health status of individuals on renal dialysis. Ann Periodontol 1998;3(1):197–205. DOI: 10.1902/annals.1998.3.1.197.
  3. Chamani G, Zarei MR, Radvar M, et al. Oral health status of dialysis patients based on their renal dialysis history in Kerman, Iran. Oral Health Prev Dent 2009;7(3):269–275. PMID: 19780434.
  4. Souza CM, Braosi APR, Luczyszyn SM, et al. Oral health in Brazilian patients with chronic renal disease. Rev Med Chile 2008;136(6):741–746. DOI: 10.4067/S0034-98872008000600008.
  5. Mechanic D. Emerging trends in the application of the social sciences to health and medicine. Soc Sci Med 1995;40(11):1491–1496. DOI: 10.1016/0277-9536(95)00024-2.
  6. Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life: a conceptual model of patient outcomes. JAMA 1995;273(1):59–65. DOI: 10.1001/jama.1995.03520250075037.
  7. Decker SD, Schultz R, Wood D. Determinants of well‐being in primary caregivers of spinal cord injured persons. Rehabil Nurs 1989;14(1):6–8. DOI: 10.1002/j.2048-7940.1989.tb00664.x.
  8. Sprangers MAG, Aaronson NK. The role of health care providers and significant others in evaluating the quality of life of patients with chronic disease: a review. J Clin Epidemiol 1992;45(7):743–760. DOI: 10.1016/0895-4356(92)90052-O.
  9. Kralik D, van Loon A, Visentin K. Resilience in the chronic illness experience. Educ Action Res 2006;14(2):187–201. DOI: 10.1080/09650790600718035.
  10. Gerritsen AE, Allen PF, Witter DJ, et al. Tooth loss and oral health-related quality of life: A systematic review and meta-analysis. Health Qual Life Outcomes 2010;8(1):126. DOI: 10.1186/1477-7525-8-126.
  11. Rodakowska E, Wilczyńska-Borawska M, Fryc J, et al. Oral health-related quality of life in patients undergoing chronic hemodialysis. Patient Prefer Adherence 2018;12:955–961. DOI: 10.2147/PPA.S161638.
  12. Tsakos G, Steele JG, Marcenes W, et al. Clinical correlates of oral health‐related quality of life: evidence from a national sample of British older people. Eur J Oral Sci 2006;114(5):391–395. DOI: 10.1111/j.1600-0722.2006.00398.x.
  13. Baba K, Igarashi Y, Nishiyama A, et al. Patterns of missing occlusal units and oral health‐related quality of life in SDA patients. J Oral Rehabil 2008;35(8):621–628. DOI: 10.1111/j.1365-2842.2007.
  14. Pallegedara C, Ekanayake L. Effect of tooth loss and denture status on oral health-related quality of life of older individuals from Sri Lanka. Community Dent Health 2008;25(4):196. PMID: 19149294.
  15. Atchison KA, Dolan TA. Development of the geriatric oral health assessment index. J Dent Educ 1990;54(11):680–687. PMID: 2229624.
  16. Kressin NR, Atchison KA, Miller DR. Comparing the impact of oral disease in two populations of older adults: application of the geriatric oral health assessment index. J Public Health Dent 1997;57(4):224–232. DOI: 10.1111/j.1752-7325.1997.tb02979.x.
  17. Ekanayake L, Perera I. The association between clinical oral health status and oral impacts experienced by older individuals in Sri Lanka. J Oral Rehabil 2004;31(9):831–836. DOI: 10.1111/j.1365-2842.2004.01311.x.
  18. Ashing-Giwa KT, Tejero JS, Kim J, et al. Examining predictive models of HRQOL in a population-based, multiethnic sample of women with breast carcinoma. Qual Life Res 2007;16(3):413–428. DOI: 10.1007/s11136-006-9138-4.
  19. Baba K, Igarashi Y, Nishiyama A, et al. The relationship between missing occlusal units and oral health-related quality of life in patients with shortened dental arches. Int J Prosthodont 2008;21(1):72. DOI: 10.1111/j.1365-2842.2007.01803.x.
  20. Mesas AE, De Andrade SM, Cabrera MAS. Factors associated with negative self‐perception of oral health among elderly people in a Brazilian community. Gerodontology 2008;25(1):49–56. Available from: DOI: 10.1111/j.1741-2358.2007.00196.x.
  21. World Health Organization. Oral health surveys: basic methods. Albany: World Health Organization; 2013.
  22. Sheiham A, Steele JG, Marcenes W, et al. The impact of oral health on stated ability to eat certain foods; findings from the national diet and nutrition survey of older people in Great Britain. Gerodontology 1999;16(1):11–20. PMID: 10687504. DOI: 10.1111/j.1741-2358.1999.00011.x.
  23. Agerberg G, Carlsson GE. Chewing ability in relation to dental and general health. Acta Odontol Scand 1981;39(3):147–153. DOI: 10.3109/00016358109162273.
  24. Tsakos G, Marcenes W, Sheiham A. The relationship between clinical dental status and oral impacts in an elderly population. Oral Health Prev Dent 2004;2(3):211. PMID: 15641624.
  25. Tan H, Peres KG, Peres MA. Retention of teeth and oral health–related quality of life. J Dent Res 2016;95(12):1350–1357. Available from: DOI: 10.1177/0022034516657992.
  26. Locker D. The burden of oral disorders in a population of older adults. Community Dent Health 1992;9(2):109. PMID: 1504877.
  27. Schmalz G, Kollmar O, Vasko R, et al. Oral health‐related quality of life in patients on chronic haemodialysis and after kidney transplantation. Oral Dis 2016;22(7):665–672. Available from: DOI: 10.1111/odi.12519.
  28. Kahar P, Chapman C, Gupta J. Assessment of the effect of oral health on quality of life and oral-health indicators among ESRD patients in southwest Florida: a pilot study. Int J Dent 2019;2019:1–9. Available from: DOI: 10.1155/2019/1608329.
  29. Vingilis E, Sarkella, J. Determinants and indicators of health and well-being: tools for educating society. Soc Indic Res 1997;40(1/2):159–178. Available from: DOI: 1006855410848.
  30. Millwood J, Heath MR. Food choice by older people: the use of semi-structured interviews with open and closed questions. Gerodontology 2000;17(1):25–32. Available from: DOI: 10.1111/j.1741-2358.2000.00025.x.
  31. Klassen JT, Krasko BM. The dental health status of dialysis patients. J Can Dent Assoc 2002;68(1):34–38. PMID: 11844416.
  32. Locker D, Matear D, Stephens M, et al. Comparison of the GOHAI and OHIP-14 as measures of the oral health-related quality of life of the elderly. Community Dent Oral Epidemiol 2001;29(5):373–381. PMID: 11553110. DOI: 10.1034/j.1600-0528.2001.290507.x.
  33. Walker RJ, Kiyak HA. The impact of providing dental services to frail older adults: Perceptions of elders in adult day health centers. Spec Care Dentist 2007;27(4):139–143. DOI: 10.1111/j.1754-4505.2007.tb00336.x.
  34. Pretty IA, Ellwood RP, Lo ECM, et al. The Seattle care pathway for securing oral health in older patients. Gerodontology 2014;31(s1):77–87. Available from: DOI: 10.1111/ger.12098.
  35. Palmqvist S, Söderfeldt B, Arnbjerg D. Self‐assessment of dental conditions: validity of a questionnaire. Community Dent Oral Epidemiol 1991;19(5):249–251. Available from: DOI: 10.1111/j.1600-0528.1991.tb00160.x.
  36. Petersen PE. The world oral health report 2003: continuous improvement of oral health in the 21st century – the approach of the WHO global oral health programme. Community Dent Oral Epidemiol 2003;31(s1):3–24. DOI: 10.1046/j.2003.com122.x.
  37. Heath MR, Wright P. The teaching of prosthodontic care for older people: a non‐rote philosophy. Gerodontology 1997;14(2):113–118. Available from: DOI: 10.1111/j.1741-2358.1997.00113.x.
  38. Gerritsen AE, Witter DJ, Bronkhorst EM, et al. An observational cohort study on shortened dental arches—clinical course during a period of 27–35 years. Clin Oral Invest 2012;17(3):859–866. DOI: 10.1007/s00784-012-0765-6.
  39. Griffin SO, Jones JA, Brunson D, et al. Burden of oral disease among older adults and implications for public health priorities. Am J Public Health 2012;102(3):411–418. Available from: DOI: 10.2105/ajph.2011.300362.
  40. Thomson WM, Ma S. An ageing population poses dental challenges. Singapore Dent J 2014;35:3–8. DOI: 10.1016/j.sdj.2014.10.001.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.