Assessment of the Effects of Occluding Pairs of Teeth on Oral Health-related Quality of Life among Dialysis Patients

Aim: To determine oral health-related quality of life (OHRQoL) in hemodialysis patients and assess if location and distribution of teeth had perceived oral impacts. Materials and methods: Face-to-face interviews and oral examinations were conducted among 96 patients in southwest Florida. Sociodemographic data in addition to self-reported medical conditions were collected. OHRQoL was determined using the Geriatric Oral Health Assessment Index (GOHAI-12). Presence of decayed teeth, missing teeth, anterior occluding pairs (AOPs) and posterior occluding pairs (POPs), and community periodontal index were ascertained through oral examinations. Results: Mean age was 64.81 ± 12.9 years. Mean number of teeth present was 20.12 ± 10.8. Nearly half (48%) of the participants had >1 decayed teeth. Among those examined for periodontal health, 86% had some form of periodontal disease. Mean AOP was 4.4 ± 2.3 and mean POP was 4.2 ± 3.1. Median GOHAI-12 score was 52. Limiting the kinds or amounts of food (p = 0.040), trouble biting or chewing (p = 0.010), feeling uncomfortable eating in front of people (p = 0.024), and pleased with looks (p = 0.038) were statistically significant for AOP groups. Only trouble biting or chewing (p = 0.044) and pleased with looks showed significant association with POP groups (p = 0.038). In adjusted regression analyses, participants with AOPs 0 to 2 had 86% lower odds of reporting GOHAI-12 scores above 40 (25th percentile) than the group with AOPs 3 to 6 (odds ratio = 0.14; 95% confidence interval = 0.04-0.58). Conclusion: The study highlights fewer AOP to have a larger effect than POP not only in the psychosocial dimension but also in the functional abilities. Lower GOHAI-12 scores were associated with AOP 2 or less than 2 in the study sample. Clinical significance: While treatment and management of oral health problems in dialysis patients are complicated by the presence of co-morbidities, age-related changes in the mouth, and issues of access to dental care, identification, repair, or replacement of strategically important teeth using the “shortened dental arch principle” to maintain oral function among hemodialysis patients are recommended.