Predictors of oral health-related quality of life in stroke patients

Abstract

Objectives: To examine clinical and socio-demographic predictors of OHRQoL in patients following stroke. Methods: A group of 81 patients were enrolled in a randomized controlled clinical trial which provided oral hygiene interventions [(1) oral hygiene instruction (OHI) only, (2) OHI and 0.2% chlorhexidine(CHX) mouthrinse, or (3) OHI, 0.2% CHX mouthrinse, and assisted brushing] over a three week period during in-hospital rehabilitation. OHRQoL was measured by the Oral Health Impact Profile-14 (OHIP-14) prior to intervention initiation, and following completion of the clinical trial. Objective clinical oral health indicators (caries status, denture status, number of teeth, number of posterior occluding tooth pairs, dental plaque and gingival bleeding scores), socio-demographic (age, gender, educational attainment, receipt of financial assistance, employment status) and behavioral variables (dental attendance, toothbrushing habits), as well as stroke-related outcomes (functional disability, previous stroke, swallowing impairment, dominant side affected) were examined for their association with OHIP-14 scores.

Results: Significant improvements in OHRQoL were observed over the course of the clinical trial for all patients as a whole (p<0.05), while OHIP-14 change scores did not significantly differ between treatment groups. In a negative binomial regression model for OHIP-14 scores at baseline, lack of tertiary education (rate ratio: 3.37, p<0.05, 95%CI: 1.25-9.06) was the only factor associated with OHRQoL. Baseline OHIP-14 scores were associated with scores at three weeks (rate ratio: 1.06, p<0.001, 95%CI: 1.03-1.09).

Conclusions:

OHRQoL is compromised following stroke and is associated with educational attainment level upon admission. While significant improvements in OHRQoL are observed following rehabilitation, subsequent OHRQoL is significantly associated with OHRQoL at baseline.