Basic and patient-oriented research
Impact of Symptomatic Pericoronitis on Health-Related Quality of Life

https://doi.org/10.1016/j.joms.2008.07.005Get rights and content

Purpose

To assess the impact of symptomatic pericoronitis on health-related quality of life (HRQOL).

Patients and Methods

Healthy subjects with symptomatic pericoronitis were enrolled in an institutional review board-approved study. Each was given a third molar condition-specific HRQOL instrument to assess the impact of pericoronitis in the preceding week. Lifestyle and oral-function outcomes were assessed using a 5-point Likert-type scale, with anchors of “no trouble” (1) and “lots of trouble” (5). Pain outcomes were assessed using a 7-point scale anchored by “no pain” (1) and “worst pain imaginable” (7). Verbal descriptors for sensory perception and unpleasantness of pain were recorded on Gracely scales. The impact of symptomatic pericoronitis on overall health and well-being in the previous 3 months was recorded using the Oral Health Impact Profile (OHIP-14).

Results

The median age of 57 subjects was 23.1 years (interquartile range [IQR], 21.2 to 25.8 years). Forty-nine percent were female, 56% were Caucasian, 21% were Asian, and 16% were African American. Ninety-one percent had at least some college experience. Twenty-eight percent of subjects described their worst pain in the week before enrollment as severe (5-7/7), 40% as moderate (3-4/7), and 32% as none/little (1-2/7). Average pain in the previous week was described as severe (5-7/7) for 4% of subjects, as moderate (3-4/7) for 40%, and as none/little (1-2/7) for 56%. On the Gracely scales, 9% of subjects reported the sensory intensity of pain in the past week as “intense,” “very intense,” or “extremely intense.” Subjects reported “quite a bit/lots” of difficulty (4-5/5) with oral function (23% with eating, 19% with chewing, and 6% with opening) and “quite a bit/lots” of difficulty (4-5/5) with lifestyle (sleeping, social life, and sports/hobby, all at 2%). The median OHIP-14 Severity score was 11/56 (IQR, 5-17). The most frequently reported OHIP-14 items in the 3 months before enrollment were in the pain dimensions. The median Severity score for pain items was 4/8 (IQR, 2-6).

Conclusion

Symptomatic pericoronitis can have adverse outcomes, compromising the quality of life and inflicting pain.

Section snippets

Patients and Methods

The data for these analyses on HRQOL are from subjects diagnosed with mild symptoms of pericoronitis, recruited for an institutional review board-approved, prospective, exploratory clinical trial. Patients presenting consecutively during 2006 and 2007 to an academic clinical center were asked to participate.

Inclusion criteria dictated that subjects were at risk assessment level I or II according to the standards of the American Society of Anesthesiologists, between ages 18 and 35 years, and

Results

The median age of 57 subjects with symptomatic pericoronitis was 23.1 years (interquartile range [IQR], 21.2 to 25.8 years) (Table 2). Slightly more males (51%) than females participated. Fifty-six percent of respondents were Caucasian, 21% were Asian, and 16% were African American. All subjects were at least high school graduates. Ninety-one percent had experienced at least some college.

Subjects' reports of worst pain and average pain in the week before enrollment are detailed in Figure 1.

Discussion

The most clinically relevant finding of these analyses is that symptomatic pericoronitis was associated with substantial adverse outcomes affecting quality of life and pain over a time frame of days to weeks. Importantly, these measures of pain and oral function appeared to be negatively affected in these subjects at levels similar to those reported for the principal treatment of this condition, third molar removal.15, 22

On postsurgery day (PSD) 1, Shugars et al reported “worst pain” as severe

Acknowledgments

The authors thank the patients who volunteered to provide data for these analyses. The authors also thank Ms Debora Price for helping manage the data for this project, and Ms Tiffany Hambright for her assistance as clinical coordinator.

References (25)

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    The reason for the development of pericoronitis in mandibular molars is due to the presence of more limitations and exigency during the process of eruption, generally due to misaligned teeth or lack of space [2,3]. If the local inflammatory response limited to the tooth exaggerates, then there is a likely risk of developing systemic dissemination of the bacterial infection [4]. Th goal of the dental practitioner is to either extract or retain the molar associated with pericoronitis [5].

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    McGrath and Bedi4 reported that the OHIP-14 index is more sensitive to improvements in oral health. Many studies have evaluated the effect of pericoronitis on the QoL rated by the OHIP-14 index1,4,7–10,15,16 and pericoronitis was treated with tooth extraction, which was reported to improve quality of life. A report by McGrath and Bedi that evaluated the removal of a single lower third molar with pericoronitis showed greater changes for the better in the severity scores in the OHIP-14 index at six months compared with the preoperative period.

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This research was supported by GCRC RR00046, CPSA U54RR024383, Oral and Maxillofacial Surgery Foundation, and the American Association of Oral and Maxillofacial Surgeons.

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