Nadia Elgendy: Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia. ORCID
Khalid Aboalshamat: Dental Public Health Division, Preventative Dentistry Department, College of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia. ORCID
Hamzah Ali Babkair: Department of Oral Basic and Clinical Sciences, College of Dentistry, Taibah University, Madinah, Saudi Arabia. ORCID
Richeal Ni Riordain: Oral Medicine, UCL Eastman Dental Institute, London, UK. ORCID
BACKGROUND: The objective of the present study was to identify the impact of systemic sclerosis (SSc) upon oral health-related quality of life (OHRQoL) of affected individuals resident in the UK. METHODS: A total of 100 patients and their partners or carers were invited to complete questionnaires regarding the impact of SSc on quality of life and psychological well-being using valid and reliable patient-reported outcome measures (OHIP-14, MHISS, OIDP, MDAS and HADS). A total of 50 patients with SSc and 18 partners or carers who acted as controls returned the completed questionnaires. Statistical analyses were performed for comparisons of different variables. RESULTS: All the mean scores of OHIP-14 (SSc [16.5 ± 12.4] Vs controls [6.06 ± 7.6, p = 0.001]) and MHISS components were significantly higher in patients than those of control group (SSc [21.26 ± 12] Vs controls [4.8 ± 7.3, p < 0.0001]). Majority of OIDP mean scores were significantly worse in patients compared with controls [SSc (10 ± 8.7) Vs controls (1.72 ± 3.4, p < 0.0001)]. The mean of total MDAS [SSc (11.7 ± 5.3) Vs controls (9.5 ± 4.4)] and HADS scores were higher in patients compared to controls (SSc depression [4.8 ± 3.3] and anxiety [6 ± 4.6] Vs controls [3.7 ± 3.1] [4.7 ± 3.9]). CONCLUSIONS: Although the present study is limited by the low response rate and its cross-sectional design, present results highlighted that systemic sclerosis has a negative impact on OHRQoL of the affected individuals; hence, the evaluation of associated psychological impact including anxiety and depression symptoms is needed to better understand, monitor and evaluate the disease comorbidity in patients with SSc.
Stern EP, Denton CP. The pathogenesis of systemic sclerosis. Rheum Dis Clin North Am. 2015;41:367-382.
Del Rosso A, Mikhaylova S, Baccini M, Lupi I, Matucci Cerinic M, Maddali BS. In systemic sclerosis, anxiety and depression assessed by hospital anxiety depression scale are independently associated with disability and psychological factors. Biomed Res Int. 2013;2013:507493.
Willems LM, Kwakkenbos L, Leite CC, et al. Frequency and impact of disease symptoms experienced by patients with systemic sclerosis from five European countries. Clin Exp Rheumatol. 2014;32(6 Suppl 86):S88-S93.
Sumpton D, Thakkar V, O'Neill S, Singh-Grewal D, Craig JC, Tong A. "It's Not Me, It's Not Really Me." insights from patients on living with systemic sclerosis: an interview study. Arthritis Care Res. 2017;69:1733-1742.
Royle JG, Lanyon PC, Grainge MJ, Abhishek A, Pearce FA. The incidence, prevalence, and survival of systemic sclerosis in the UK clinical practice research datalink. Clin Rheumatol. 2018;37:2103-2111.
Smirani R, Truchetet ME, Poursac N, Naveau A, Schaeverbeke T, Devillard R. Impact of systemic sclerosis oral manifestations on patients’ health-related quality of life: a systematic review. J Oral Pathol Med. 2018;47:808-815.
Jung S, Martin T, Schmittbuhl M, Huck O. The spectrum of orofacial manifestations in systemic sclerosis: a challenging management. Oral Dis. 2016;23:424-439.
Veale BJ, Jablonski RY, Frech TM, Pauling JD. Orofacial manifestations of systemic sclerosis. Br Dent J. 2016;221:305-310.
Bajraktari IH, Kryeziu A, Sherifi F, Bajraktari H, Lahu A, Bajraktari G. Oral manifestations of systemic sclerosis and correlation with anti-topoisomerase I antibodies (SCL-70). Med Arch. 2015;69:153-156.
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(Suppl 1):3-23.
Maddali Bongi S, Del Rosso A, Mikhaylova S, Baccini M, Matucci CM. Sexual function in Italian women with systemic sclerosis is affected by disease-related and psychological concerns. J Rheumatol. 2013;40:1697-1705.
Maddali-Bongi S, Del Rosso A, Mikhaylova S, et al. Impact of hand and face disabilities on global disability and quality of life in systemic sclerosis patients. Clin Exp Rheumatol. 2014;32(6 Suppl 86):S15-S20.
Baron M, Hudson M, Tatibouet S, et al. The Canadian systemic sclerosis oral health study: orofacial manifestations and oral health-related quality of life in systemic sclerosis compared with the general population. Rheumatology. 2014;53:1386-1394.
Baron M, Hudson M, Tatibouet S, et al. The Canadian systemic sclerosis oral health study II: the relationship between oral and global health-related quality of life in systemic sclerosis. Rheumatology. 2015;54:692-696.
Mouthon L, Rannou F, Berezne A, et al. Development and validation of a scale for mouth handicap in systemic sclerosis: the mouth handicap in systemic sclerosis scale. Ann Rheum Dis. 2007;66:1651-1655.
Maddali Bongi S, Del Rosso A, Miniati I, et al. The Italian version of the mouth handicap in systemic sclerosis scale (MHISS) is valid, reliable and useful in assessing oral health-related quality of life (OHRQoL) in systemic sclerosis (SSc) patients. Rheumatol Int. 2012;32:2785-2790.
Schouffoer AA, Strijbos E, Schuerwegh AJ, Mouthon L, Vliet Vlieland TP. Translation, cross-cultural adaptation, and validation of the mouth handicap in systemic sclerosis questionnaire (MHISS) into the Dutch language. Clin Rheumatol. 2013;32:1649-1655.
Desbois AC, Cacoub P. Systemic sclerosis: an update in 2016. Autoimmun Rev. 2016;15:417-426.
Denton CP. Advances in pathogenesis and treatment of systemic sclerosis. Clin Med. 2016;16:55-60.
Locker D, Allen PF. Developing short-form measures of oral health-related quality of life. J Public Health Dent. 2002;62:13-20.
Honarmand K, Feinstein A. Validation of the hospital anxiety and depression scale for use with multiple sclerosis patients. Mult Scler. 2009;15:1518-1524.
Humphris G, Crawford JR, Hill K, Gilbert A, Freeman R. UK population norms for the modified dental anxiety scale with percentile calculator: adult dental health survey 2009 results. BMC Oral Health. 2013;13:29.
Locker D, Clarke M, Payne B. Self-perceived oral health status, psychological well-being, and life satisfaction in an older adult population. J Dent Res. 2000;79:970-975.
Nguyen C, Ranque B, Baubet T, et al. Clinical, functional and health-related quality of life correlates of clinically significant symptoms of anxiety and depression in patients with systemic sclerosis: a cross-sectional survey. PLoS One. 2014;9:e90484.
Kwakkenbos L, Delisle VC, Fox RS, et al. Psychosocial aspects of scleroderma. Rheum Dis Clin North Am. 2015;41:519-528.
Johnson J, Johansson M, Ryden A, Houltz E, Finizia C. Impact of trismus on health-related quality of life and mental health. Head Neck. 2015;37:1672-1679.
Milette K, Thombs BD, Dewez S, Korner A, Pelaez S. Scleroderma patient perspectives on social support from close social relationships. Disabil Rehabil. 2019;42:1588-1598.
Hill KB, Chadwick B, Freeman R, O'Sullivan I, Murray JJ. Adult dental health survey 2009: relationships between dental attendance patterns, oral health behaviour and the current barriers to dental care. Br Dent J. 2013;214:25-32.
ADHS. ADHS. 2009. https://digital.nhs.uk/data-and-information/areas-of-interest/public-health/adult-dental-health-survey. Accessed November 29, 2018.
Abdouh I, Porter S, Fedele S, Ni RR. Validity and reliability of the mouth handicap of systemic sclerosis questionnaire in a UK population. J Oral Pathol Med. 2020;49:986-993.
