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

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

Anna-Lena Hillebrecht

Doctoral thesis

Date of Examination: 2020-03-26

Date of issue: 2020-03-16

Advisor: Wiegand, Annette Prof. Dr.

Referee: Zerr, Inga Prof. Dr.

Referee: Meyer, Thomas Prof. Dr.

Persistent Address: http://hdl.handle.net/21.11130/00-1735-0000-0005-1361-8

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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