The influence of oral health and psycho-social well-being on clinical outcomes in Behçet’s disease

Abstract

This study was designed to investigate the association of oral ulceration and oral health factors, together with psycho-social well-being in Behçet’s disease (BD), and to clarify the importance of psycho-social support of patients in the overall management of BD. The study comprised of a cohort of 146 BD patients (mean age ± SD = 39.65 ± 13.20) and 20 recurrent aphthous stomatitis (RAS) patients (mean age ± SD = 42.32 ± 11.32). Oral ulcer severity score (OUSS), Behçet’s disease current activities form (BDCAF), hospital anxiety and depression scale (HADS), and the work and social adjustment scale (WSAS) were investigated. Oral health risk factors were also included. The analysis of variance, regression, and factor analysis were used to scrutinise the data. Almost 73% of patients were at high caries risk in BD and RAS groups. Thirty-nine percent of BD and forty percent of RAS had a score of BPE3 (probing depth 3.5–5.5 mm). Regression analysis revealed that OUSS and WSAS had a positive impact to increase the BDCAF score in BD patients (β = 0.395, P = 0.001; β = 0.240, P = 0.019), respectively. Dental health, periodontal health, anxiety, depression, and WSAS variables had strong loadings by factor analysis based on gender and at the time of present and absent of oral ulceration. The main oral ulcer characteristics that had significant influences on the total of oral health quality of life by 68.6% were: size, duration, ulcer-free period, and pain. The results highlighted the significant influence of oral ulceration, patients’ oral health, diet, and psycho-social well-being as multi-factorial causes on increasing disease activity in BD patients.Electronic supplementary materialThe online version of this article (10.1007/s00296-018-4117-y) contains supplementary material, which is available to authorized users.

Moderation analysis exploring associations between age and mucocutaneous activity in Behçet’s syndrome: A multicenter study from Turkey

“…4,[7][8][9][10][11][27][28][29][30][31] Mucocutaneous manifestations are common clinical conditions and affect the patients' lives poorly. 9,10,32,33 In the present study, validated MI as an organ-specific activity index was used to evaluate mucocutaneous activity regarding oral ulcer, genital ulcer and erythema nodosum. 2 Because pain and functional limitation were the main domains in each subgroup score correlating with symptom patterns, clinical manifestations were easily monitored by MI.…”

“…These results are in accordance with previous studies. 9,10,12,36 These patients are not aggressively treated, as their manifestations do not have mortality risk and do not lead to permanent damage compared with those with major organ involvement. 3,10,[37][38][39] The effect of age on mucocutaneous manifestations was shown with two different analyses in our study.…”

“…Therefore, user‐friendly, patient‐driven activity indices are valuable tools to measure clinical progress from the BS patient’s perspective. Yet, “what to measure” and “how to measure” are critical points owing to the diversity of organ involvement in BS 4,7–11,27–31 …”

Oral and Maxillo-Facial Manifestations of Systemic Diseases: An Overview

“…[ 66 , 67 ]. Since no pertinent serological and/or bio-chemical activity markers exist for diagnosis and monitoring the disease, both are essentially based on the exanimation of lesions, symptoms and detailed medical history [ 68 , 69 , 70 , 71 ]. In fact, several systems for measurement (both scores and indexes) of patient-reported outcomes exist to better manage Behcet’s syndrome, some validate as disease-specific (Total Activity Index, Behcet’s Disease Current Activity Form, Behcet’s Syndrome Activity Scale) and other as organ-specific (Oral Ulcer Severity Score, Genital Ulcer Severity Score, Composite Index for oral ulcers and Muco-cutaneous Index) [ 72 , 73 ].…”

Comparability of European League Against Rheumatology-Recommended Pharmacological Treatments of Oral Ulcers Associated with Behçet’s Disease: A Systematic Literature Review of Randomized Controlled Trials

“…12,13 The high prevalence and recurrence of oral ulcers and their negative impact on the clinical and humanistic burden of disease represent an important opportunity for treatment. Oral ulcers can lead to poor dental hygiene, [14][15][16] limit essential daily activities like eating and talking, 16 and impair quality of life (QoL) overall and across several domains, such as physical and social functioning, sleep and fatigue, and mental health. 8,[17][18][19] Furthermore, patients with BD who have oral ulcers have reduced QoL compared with healthy controls and patients with other chronic conditions.…”