Association between periodontitis and oral health-related quality of life in patients with systemic conditions: A meta-analysis.

BACKGROUND

The objective of this systematic review is to evaluate whether periodontitis is associated with impaired oral health-related quality of life (OHRQoL) in adults with systemic conditions.

METHODS

Five databases were searched to identify observational studies that tested the association between periodontitis (diagnosed by clinical periodontal examination) and OHRQoL (validated instrument). Random-effects models were applied in the meta-analyses, and the Newcastle-Ottawa Scale (NOS) was used for quality assessment.

RESULTS

Seventeen studies were included, with 94.1% using the OHIP-14 instrument. Only one study was rated as high quality. Meta-analysis showed a small and significant association between periodontitis and impaired OHRQoL (SMD: 0.31; 95% CI: 0.03-0.59). Individuals with periodontitis had higher OHIP-14 scores than the comparison group (MD: 2.29; 95% CI: 0.24-4.33). Studies using the 2017 periodontitis classification yielded significantly higher estimates than those using earlier criteria. Furthermore, a strong negative impact of periodontitis on OHRQoL was observed among individuals with psoriasis, whereas no significant association was identified for other systemic conditions.

CONCLUSIONS

Periodontitis has a small negative impact on OHRQoL in patients with comorbidities. The type of systemic condition and the periodontitis diagnostic criteria influence this association.

PLAIN LANGUAGE SUMMARY: Periodontitis negatively impacts oral health-related quality of life across different populations. However, this impact may appear smaller in individuals with certain systemic conditions, as additional health challenges can overshadow the perceived effects of periodontitis on daily life. Our systematic review found a small negative impairment of OHRQoL associated with periodontitis in patients with comorbidities, with the magnitude of this association influenced by the type of systemic condition and the diagnostic criteria used to define periodontitis. Further high-quality studies are needed to strengthen the current evidence.