Die Auswirkungen der zahnärztlichen Behandlung in Intubationsnarkose auf die mundgesundheitsbezogene Lebensqualität von Patienten mit kognitiver Einschränkung

Changes in the oral health-related quality of life in adult patients with intellectual disabilities after dental treatment under general anesthesia

by Anna-Lena Hillebrecht
Doctoral thesis
Date of Examination:2020-03-26
Date of issue:2020-03-16
Advisor:Prof. Dr. Annette Wiegand
Referee:Prof. Dr. Inga Zerr
Referee:Prof. Dr. Thomas Meyer
Persistent Address: http://dx.doi.org/10.53846/goediss-7863

 

 

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Abstract

English

OBJECTIVES: This study aimed to assess self- and proxy-rated changes in the oral health-related quality of life (OHRQoL) in adult patients with intellectual disabilities after dental treatment in general anesthesia. METHODS: The OHRQoL in 52 adult patients with intellectual and developmental disabilities was assessed prior to dental treatment in general anesthesia (t0), 2 to 3 (t1) and 12 weeks (t2) postoperatively. Therefore, patients and primary cargivers were surveyed using either the 5-item short form of the Oral Health Impact Profile translated into easy language (OHIP-G5-easy, self-rating, n = 27) or the 14-item short form of the Oral Health Impact Profile (OHIP-G14, proxy-rating, n = 51), respectively. OHIP-G5-easy and OHIP-G14 summary scores were statistically analyzed with non-parametric mixed effects models and spearman correlation (p < 0.05). Additionally, the effect of demographic, anamnestic, oral health and treatment factors on QHRQoL or on changes of OHRQoL were analyzed using univariate and multivariate ordinal logistic regressions (p < 0.05). RESULTS: Self- (t0: 5.8 ± 4.6, t1: 4.3 ± 5.9, t2: 2.0 ± 3.9) and proxy-ratings (t0: 18.8 ± 11.6, t1: 10.1 ± 11.2, t2: 2.7 ± 5.3) revealed a significant improvement of OHRQoL after dental treatment in general anesthesia. Data showed a moderate correlation (p < 0.001, rSp = 0.43). OHRQoL at baseline was affected by the etiology of cognitive impairment and by the periodontal status (OHIP-G14). Improvement of OHRQoL was associated with the etiology of cognitive impairment (OHIP-G14) and the extent of dental treatment (OHIP-G5-easy). CONCLUSION: Self- and proxy-ratings revealed a significant improvement of OHRQoL in patients with intellectual disabilities after dental treatment in general anesthesia. CLINICAL RELEVANCE: Assessment of OHRQoL promotes patient-centred care of adults with intellectual disabilities.
Keywords: Dental treatment; general anesthesia; intellectual disabilities; oral health impact profile; oral health related quality of life; Self- and proxy-rating
Schlagwörter: Patienten mit Behinderung; zahnärztliche Behandlung in Intubationsnarkose; Mundgesundheitsbezogene Lebensqualität; kognitive Beeinträchtigung; Fremdbefragung; Selbstbefragung; OHIP
 
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