The relationship between psychosocial distress and oral health status in patients with facial burns and mediation by oral health behaviour

Abstract

Background There is limited discussion on the influence of psychosocial factors on the oral health of patients with a facial burn injury. This report investigated the relationship between oral health and psychosocial distress in patients with facial burns and the role of oral health behaviour in mediating the relationship. Methods The data were part of a cross-sectional study that had systematically and randomly selected patients with > 10% total burn surface area from a burn centre in Pakistan. The oral health status (DMFT, CPI, OHI-S) and severity of facial disfigurement were assessed. Validated instruments in the Urdu language were self-administered and information relating to oral health behaviour (brushing and dental visits), oral health-related quality of life (OHIP-14), satisfaction with appearance, self-esteem, anxiety and depression, resilience, and social support were collected. The statistical analyses included simple linear regression, Pearson correlation, t-test, and ANOVA. Mediation analysis was carried out to examine the indirect effect by oral health behaviour. Results From a total of 271 participants, the majority had moderate to severe facial disfigurement (89%), low self-esteem (74.5%), and moderate to high levels of social support (95%). The level of satisfaction with appearance was low, whereas anxiety and depression were high. Disfigurement and satisfaction with appearance were associated with lower self-esteem and social support (p < 0.05). Greater severity of disfigurement, higher levels of anxiety and dissatisfaction with appearance, and lower levels of self-esteem and social support were associated with greater DMFT and OHIP-14 scores, worse periodontal and oral hygiene conditions, and less frequent tooth brushing and dental visits (p < 0.05). The main barriers to oral healthcare utilization were psychological and social issues (p < 0.05). The indirect effect by oral health behaviour was not significant for anxiety but was significant for disfigurement, satisfaction with appearance, self-esteem, and social support. Conclusion There is an association between the psychosocial factors and oral health of patients with facial burns through a direct effect and mediation by oral health behaviour.

Evaluating a linkage between obesity and the occurrence of dental caries among school going children in Sakaka, Al Jouf, Kingdom of Saudi Arabia

“…This finding was statistically insignificant. This result was in line with the results of the previous studies where a greater risk of dental caries was related to irregular tooth brushing habits ( Ashour, Ashour & Basha, 2018 ; Chaudhary & Ahmad, 2021 ; Chaudhary, Ahmad & Bashir, 2019 ; Chaudhary, Ahmad & Sinor, 2021 ; Farooqi et al, 2015 ). Additionally, other oral hygiene habits like usage of dental floss and mouthwash/rinsing habits were found to be not significant among the study participants.…”

“…Another aspect of an inverse association of snacking with dental caries is the increased secretion of saliva due to more food consumption by obese people that could eventually reduce the incidence of caries owing to its protective effect. Additionally, studies have mentioned other factors such as poverty and low socioeconomic status that explain the relationship of being underweight and having more dental caries ( Chaudhary & Ahmad, 2021 ; Chaudhary, Ahmad & Bashir, 2019 ; Farsi et al, 2016 ; Kumar et al, 2017 ).…”

The severity of facial burns, dental caries, periodontal disease, and oral hygiene impact oral health-related quality of life of burns victims in Pakistan: a cross-sectional study

“…The results of this study should be interpreted with caution due to the limitations mentioned earlier and in related publications [30,56]. A reliability study for the clinical measurements was not performed because the participants were not willing to return for re-assessment.…”

“…Nevertheless, more evidence is needed to reaffirm the observations. A recent study showed that psychosocial distress can affect oral health through oral health behaviour [ 56 ].…”

Work-Related Musculoskeletal Disorders and Their Associated Risk Factors among Pakistani Dental Practitioners: A Cross-Sectional Study

“…In another study, WMSD pain was found more prevalent in female dentists and wrist pain occurs more often in oral surgeons compared to other dental professionals [ 13 ]. Some studies have correlated risk factors of WMSD among dentists with individual characteristics, physical load, and psychosocial factors [ 14 – 17 ]. However, most of the previous on WMSD among dental professionals were conducted in the western and developed nations, and only a few studies reported WMSD among dentists from the South Asia region.…”