Association between Dentin Hypersensitivity and Health/Oral Health-related Quality of Life: A Systematic Review and Meta-Analysis

ABSTRACT Objective: To investigate the association between DH and Health (HRQoL) or Oral Health-Related Quality of Life (OHRQoL). Material and Methods: PubMed, Web of Science, Scopus, EMBASE, Cochrane, Scielo, LILACS/BBO, Biblioteca Digital de Teses e Dissertações (BDTD), Open Grey, and Google Scholar databases were screened in September 2019 (updated in October 2022). Observational studies were selected to compare HRQoL/OHRQoL(outcome) according to DH(exposure) or evaluate the association among these variables. Standardized Joanna Briggs Institute critical appraisal tool for analytical cross-sectional studies was used to analyze the risk of bias. A random-effects meta-analysis was conducted to synthesize evidence for the association between DH and OHRQoL. Results: 10 papers met inclusion criteria and were evaluated. In most studies, presenting or having a greater intensity of DH was associated with a negative impact on one's quality of life. However, most of these studies showed a moderate to high risk of methodological bias. The consistent finding from studies with a low risk of bias suggests a significant association between DH and OHRQoL. Meta-analysis was feasible for three studies with substantial heterogeneity. The pooled Odds Ratio was 2.14 (95%CI 1.15-3.99; I2= 57,44%). Conclusion: Many studies presented a high risk of bias; therefore, the actual effect of DH on one's quality of life remains uncertain.

Hipersensibilidade dentinária e satisfação com a saúde mediada pela presença de impacto físico e psicossocial das condições bucais: uma análise de caminhos / Dentin hypersensitivity and health satisfaction mediated by the presence of physical and psychosocial impacts of oral conditions: a pathway analysis

Objetivo: Objetivou-se investigar associação direta e mediada pela presença de impacto físico e psicossocial das condições bucais entre HD e satisfação com a saúde entre adultos. Métodos: Estudo transversal foi realizado entre 2018-2019 com amostra probabilística por conglomerado de adultos residentes em Rio Acima (MG). Entrevista e exame bucal foram realizados por examinadoras calibradas. Satisfação com a saúde foi avaliada por meio da pergunta doWHOQoL-bref "Quão satisfeito (a) você está com a sua saúde?" e suas respostas categorizadas entre "satisfeito" e "insatisfeito". HD foi avaliada por estímulo tátil na região cervical dos dentes. Presença de impactos físicos e psicossociais das condições bucais foi definida pelas respostas "repetidamente" ou "sempre" a pelo menos um dos itens do OHIP-14. Covariáveis foram dados sociodemográficos e econômicos, comportamentos em saúde, condições de saúde bucal e uso de serviços odontológicos. Associações foram investigadas por modelos de Regressão de Poisson e Modelagem de Equações Estruturais (MEE) para estimar associações diretas e indiretas (Stata 16). Resultados: Dos 197 adultos, 132 (66,18%) declararam estar satisfeitos com sua saúde e 73 indivíduos (38,75%) apresentavam HD. Houve associação significativa entre presença de HD e presença de impacto físico e psicossocial das condições bucais (RP: 1.34; IC 95%: 1.08­1.67), enquanto para satisfação a associação com HD não foi significativa (RP: 1.08; IC 95%: 0.75-1.54) após a inclusão da variável presença de impacto físico e psicossocial das condições bucais. MEE demonstrou associação direta não significativa entre HD e satisfação, enquanto a associação indireta mediada pela presença de impacto físico e psicossocial das condições bucais foi significativa. Conclusão: Indivíduos com HD podem relatar maior insatisfação com a vida quando esta experiência dolorosa está associada com impactos físicos ou psicossociais.

Aim: Dentin Hypersensitivity (DH) is a painful condition that affects the Oral Health-related Quality of Life and can affect the satisfaction with health of individuals who have it. This study aimed to investigate the direct association mediated by the presence of physical and psychosocial impacts of oral conditions between DH and satisfaction with health among adults. Methods: A cross-sectional study was carried out between 2018-2019 with a probabilistic sample consisting of a cluster of adults living in Rio Acima (MG). Interviews and epidemiological examinations were performed using calibrated tests. The dependent variable of satisfaction with health was assessed using the WHOQoL-bref question "How satisfied are you with your health?" Participants' answers were categorized between "satisfied" and "dissatisfied". The independent DH variable was assessed by tactile stimulation in the cervical region of the teeth. The presence of physical and psychosocial impacts of oral conditions was defined by the answers "farly often" or "very often" to at least one of the OHIP-14 items. Covariates were sociodemographic and psychological data, health behavior, oral health conditions, and use of dental services. Associations were investigated by Poisson Regression and Structural Equation Modeling (SEM) models to estimate direct and indirect associations (Stata 16). Results: Of the 197 adults, 132 (66.18%) reported being satisfied with their health, and 73 individuals (38.75%) had DH. There was a significant association between the presence of DH and the presence of physical and psychosocial impacts of oral health (PR:1.34; 95% CI: 1.08­1.67), while for receiving the association with DH, it was not significant (PR:1 .08; 95% CI: 0.75-1.54) after including the presence of impact variables. SEM showed a non-significant direct association between DH and satisfaction, while the indirect association mediated by the presence of impact was significant. Conclusion: Individuals with HD may report greater dissatisfaction with life when this painful experience is associated with physical or psychosocial effects.