Impact of Periodontal Disease on the Quality of Life of Older People in Indonesia: A Qualitative Study

Abstract

Introduction: The impact of periodontal disease on oral health–related quality of life (OHRQoL) has often been investigated from a quantitative research perspective, which is based on clinical findings and an OHRQoL questionnaire. Very few studies have examined the issue from the view of qualitative research. To our knowledge, there have been no previous qualitative studies focusing the effect of periodontal disease on OHRQoL in Indonesian older people. Objectives: To explore and understand the impact of periodontal disease on the OHRQoL of older people as a subjective reflection in relation to periodontal disease experiences. Methods: Semi-structured interviews were conducted in a sample of 31 older people with generalized chronic periodontitis. Thematic analysis was used to identify the key issues in participants’ accounts. The analysis was undertaken by 2 independent coders to ensure reliability. To achieve thematic saturation, successive interviews were undertaken until 5 sequential interviews did not bring new themes. Results: Participants reported the negative effects likely related to periodontal disease. The impacts of periodontal disease were described by these older people as affecting more than pain, physical discomfort, and physical function restrictions. Periodontal disease also affected their psychological and social aspects of daily living. In addition, this study identified themes related to individual and environmental factors that may modify and personalize periodontal disease experiences. Furthermore, this study identified a misleading belief that problems related to periodontal disease were a normal part of aging, which might influence individuals’ expectations toward oral health. Relatedly, participants frequently reported that the progression of tooth mobility to tooth loss was an inevitable part of the aging process. Conclusions: Periodontal disease negatively affected participants’ OHRQoL. It is fundamental to understand older people’s perceptions toward their periodontal disease as well as individual and environmental factors that may have an influence on their periodontal disease experiences. Knowledge Transfer Statement: This study is a reflection of Indonesian older people’s subjective periodontal disease experiences. Therefore, the present study can be used to understand older people’s perceptions, attitudes, behaviors, and experiences toward periodontal disease and how this disease may affect their quality of life. This study also highlights a widespread and misleading belief that oral problems related to periodontal disease are an inevitable part of aging in this study population.

Understanding the feelings and experiences of patients with periodontal disease: a qualitative meta-synthesis

“…Satisfaction elements after treatment of dental disease 4. Improvements for voluntary dental care Hijryana [ 22 ] Indonesia Qualitative design/non-clinical setting Semi-structured interview/thematic analysis 31 (15, 16) 60–80y 1. Impairments related to PD 2.…”

“…However, five studies failed to state philosophical perspective clearly and only reported the study was qualitative or used qualitative methodology [ 19 – 23 ]. Additionally, all included studies except two [ 20 , 22 ], failed to discuss the role of the researchers and their influence on the research.…”

“…[ 19 , 20 , 22 ] As a result, some of them had to change their eating habits and avoid masticating which they used to eat, as one patient expressed “I cannot bite into an apple and eat it that way, I have got to chop it up...”[ 19 ] (P2) Some patients started masticating unilaterally [ 22 ], which may have an impact on their appearances. Moreover, the consequences of periodontitis, such as the destruction of periodontal support tissue and tooth loss subsequently, can further affect the appearance [ 22 ]. Some patients were quite concerned about their bad breath and feel embarrassed [ 19 , 22 ].…”

The Effect of Periodontal Treatment on Clinical and Biological Indicators, Quality of Life, and Oral Health in Rheumatoid Arthritis Patients: A Quasi-Experimental Study

“…Evidence suggests that chronic diseases generate an economic burden given the complex and expensive treatments needed for long periods of time [26]. It has been suggested that, similar to RA, periodontitis has an effect on general health, in terms of psychological, physical, and social aspects [27].…”

Oral Health Care Access, Inequity, and Inequality

“…Recognition of the value of quality-of-life assessments in oral health research has been demonstrated by the increasing published literature on the topic. Through semistructured interviews, Hijryana et al (2022) studied the quality of life of Indonesian elders with periodontal disease. In addition to pain, participants reported that their periodontal disease causes loss of function and adversely affects their emotional states and social interactions.…”