Association of periodontal status with patient-reported outcomes: oral health-related quality of life and dental anxiety in a cross-sectional study

This study aimed to evaluate oral health-related quality of life (OHRQoL) and dental hygiene fear across periodontal status groups, including periodontally healthy individuals and patients classified according to different stages of periodontitis, and to examine their associations with sociodemographic, behavioral, and clinical periodontal parameters.

This single-center, cross-sectional observational study included 999 participants recruited from the Periodontology Clinic of Zonguldak Bülent Ecevit University Faculty of Dentistry between December 2018 and December 2019. Participants were classified into three groups according to periodontal status: periodontally healthy individuals (n = 399), those with combined Stage I–II periodontitis (n = 300), and those with combined Stage III–IV periodontitis (n = 300). Sociodemographic characteristics, oral hygiene habits, dental attendance patterns, and smoking status were recorded using structured questionnaires. Periodontal parameters, including the plaque index, gingival index, probing depth, clinical attachment level, and tooth loss, were assessed clinically. Oral health-related quality of life and dental hygiene fear were assessed using the Oral Health Impact Profile-14 (OHIP-14) and the Dental Hygiene Fear Scale (DHFS), respectively.

The OHIP-14 total scores increased progressively with periodontal disease severity, with the highest scores observed in the combined Stage III–IV periodontitis group. Significant intergroup differences were found for most of the OHIP-14 domains, except for psychological discomfort. The DHFS scores also differed significantly among the groups and were highest in patients with combined Stage III–IV periodontitis. The OHIP-14 scores were significantly associated with marital status, education level, smoking status, tooth brushing frequency, dental visit frequency, and time since the last dental visit. DHFS scores were higher in females, married individuals, and those with lower educational levels. The OHIP-14 showed positive correlations with DHFS and clinical periodontal parameters, including plaque index, gingival index, probing depth, clinical attachment level, tooth loss, and age.

Periodontitis severity was associated with a poorer oral health-related quality of life and higher dental hygiene fear. These findings highlight the importance of incorporating patient-reported outcomes into periodontal assessment and care. Nevertheless, the possibility of residual confounding from unmeasured socioeconomic and systemic factors cannot be excluded.