Far patient assessment and classifications are based on clinical assessments made by the dental professional with little to no input from the patient. By inquiring and integrating patient-reported outcomes, the clinician can get a better assessment of the patient’s perception of the disease. This can be pivotal in-patient compliance and improved oral health. In a cohort study published in October 2018 in the Journal of Clinical Periodontology, the authors aimed to assess the association between the clinicians reported periodontal parameters and patient-reported experience.1
This study included data from 14.620 dentate patients receiving routine care by 355 dentists in 233 different non-specialist dental practices. Periodontal parameters assessed by clinicians included periodontal probing depths, bleeding on probing, and crestal bone loss visible on radiographs. Patient-reported parameters included descriptions of pain, dietary restrictions, and appearance using a 3-point Likert scale.
The prevalence of patient-reported outcomes increased with worsening or more advanced periodontal parameters. This indicates a dose-dependent association with worsening periodontal disease and reports of pain, dietary restrictions, and unhappiness related to dental appearance.
A large portion of patients evaluated presented with radiographic alveolar bone loss, yet no periodontal pockets > 4mm. This is indicative of periodontal parameters expected upon completion of periodontal therapy indicating resolution of active disease. These patients had fewer reported outcomes, which supports the beneficial effects of periodontal therapy from a clinical and patient outcome perspective.
Previous studies have confirmed the beneficial effects of periodontal therapy from a clinical and patient perspective. In one systematic review, which included 11 studies, the authors reported “improvement in all domains of oral-health related quality of life following periodontal therapy.”
In conclusion, the authors state “our results demonstrate that in a large non-specialist, general practice-based population, worse periodontal health as measured by increased probing depth, alveolar bone loss, and bleeding on probing is associated with adverse patient-reported outcomes including pain, dietary restriction, and unhappiness with the appearance in a dose-dependent fashion. Hence, prevention and successful management of periodontitis may have direct benefits on patient-reported outcomes.”
When performing periodontal assessment do you interview your patients? Will this information change the way you discuss the periodontal disease with your patients? Do you believe involving patients via interview/discussion will improve compliance?
- Sharma P, Yonel Z, Busby M, Chapple IL, Dietrich T. Association between periodontal health status and patient-reported outcomes in patients managed in a non-specialist, general dental practice. J Clin Periodontol. 2018 Dec;45(12):1440-1447. doi: 10.1111/jcpe.13022. Epub 2018 Nov 5. PMID: 30341963.