Oral Health and Quality of Life in Acromegaly: A Questionnaire-Based Study.

Background/

Objectives

Acromegaly is a rare chronic disease caused by excess growth hormone (GH) and insulin-like growth hormone 1 (IGF-1) due to a pituitary adenoma. In acromegaly patients, oral and facial manifestations, such as mandibular growth, macroglossia, and dental malocclusion, are common and can affect quality of life. The aims of the present study were to evaluate the diagnostic path of these patients, the impact that acromegaly had on their oral health, the medical figures involved, and the role played by their dentist.

Methods

The data were collected via an anonymous questionnaire to study dental health, dental care, and acromegaly diagnosis and history and via validated questionnaires. The validated questionnaires used were the ESS (Epworth Sleepiness Scale) to assess daytime sleepiness, OHIP-14 (Oral Health Impact Profile-14) to study perceptions of oral health, and AcroQoL to explore quality of life.

Results

We enrolled 90 acromegaly patients: 48% of the patients reported acromegaly oral manifestations and 73% reported facial changes. The most frequent oro-facial manifestations reported by the patients were jaw growth (41%), diastema (40%), macroglossia (39%), and increased size of cheekbones (35%). The median OHIP-14 value was 5 (min 0-max 43), and the highest values were recorded in the questions relating to pronunciation difficulties and problems eating due to dental problems, as well as discomfort with dental aesthetics. The patients' sleep quality was rated as good by 33% of patients, decent by 47%, and bad by 20%. The median ACROQol score achieved by the patients was 69 (min 19, max 98). An inverse and statistically significant correlation was observed between OHIP-14 and AcroQoL scores (Spearman correlation coefficient-0.44, p = 0.0002).

Conclusions

Oro-facial changes significantly affect quality of life in cases of acromegaly, yet dental professionals' involvement in diagnosis and management is limited. Greater awareness among and integration of dental professionals could support earlier detection and improve patient outcomes.