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Background: Oral diseases, especially periodontitis and tooth loss, are very common in patients with rheumatic diseases [1]. Oral health is also often influenced by other comorbidities diabetes mellitus, inflammatory bowel disease, cardiovascular disease, and neurodegenerative diseases.
Objectives: To compare self-perceived oral health and its domains in patients with rheumatic disease with and without comorbidities.
Methods: A cross-sectional, descriptive, and comparative study was carried out in the rheumatology service of the University Hospital “Dr. José Eleuterio González”, Mexico. Patients with a previous diagnosis of rheumatic disease were included and were administered the Geriatric/General Oral Health Assessment Index Spanish Version (GOHAI-SP) survey, which includes 12 questions on a Likert-type scale. Scores ≤44 were classified as poor oral health, moderate from 45 to 50, and good ≥51. Patients were divided into 2 groups, the first group being patients without comorbidities and the second group with comorbidities. The Kolmogorov-Smirnov test was used for the normality of quantitative variables. Qualitative variables were compared using Chi-square. Student’s t-test and Mann-Whitney U test were used to compare normal and non-normal quantitative variables respectively. A p-value <0.05 was considered for statistically significant differences.
Results: 490 patients were included: 307 (62.6%) without comorbidities and 183 (37.3%) with comorbidities; the majority were women, with a total of 279 (90.87%) and 175 (95.62%) in each group respectively. Rheumatoid arthritis (57.17%) was seen in half of the patients, followed by systemic lupus erythematosus (12.3%) and Sjögren’s syndrome (9.42%). The group with comorbidities was older (56 vs 48, p = <0.001). A significant difference was found in the self-perception of oral health between the group without comorbidity and the group with comorbidity. A statistically significant difference was found in the GOHAI-SP domains of functionality and psychosocial, getting a p-value of 0.001 and 0.036 respectively, and no statistically significant difference was found in the domain of pain and discomfort (p = 0.73). The results of the GOHAI-SP scores can be found in Table 1.
Comparison of oral self-perception in patients with rheumatic disease: without comorbidity vs with comorbidity.
| Without Comorbidities n=307 | With Comorbidities n=183 | p-value | |
|---|---|---|---|
| Sociodemographic | |||
| Female, n (%) | 279 (90.87) | 175 (95.62) | |
| Male, n (%) | 28 (9.12) | 8 (4.37) | |
| Age, median (IQR) | 48 (20) | 56 (17) | <0.001 |
| GOHAI Classification | |||
| Good, n (%) | 221 (71.98) | 112 (61.20) | 0.009 |
| Moderate, n (%) | 51 (16.61) | 32 (17.48) | |
| Poor, n (%) | 35 (11.40) | 39 (21.31) | |
| GOHAI-SP domains | |||
| Funcionality, median (IQR) | 20 (4) | 17 (5) | 0.001 |
| Psychosocial, median (IQR) | 24 (4) | 23 (5) | 0.036 |
| Pain and discomfort, median (IQR) | 8 (3) | 8 (3) | 0.73 |
n: sample number, %: percentage, IQR: interquartile range, GOHAI-SP: Geriatric/General Oral Health Assessment Index Spanish version.
Conclusion: Self-perceived oral health is significantly related to the presence of comorbidities in patients with rheumatic disease. Patients with rheumatic disease without comorbidities presented better self-perception of functionality and psychosocial well-being of oral health compared to patients with comorbidities.
REFERENCES: [1] Schmalz G, Patschan S, Patschan D, Ziebolz D. Oral-Health-Related Quality of Life in Adult Patients with Rheumatic Diseases—A Systematic Review. J Clin Med. 2020;9(4):1172.
Acknowledgements: NIL.
Disclosure of Interests: None declared.