بررسي كيفيت زندگي وابسته به سلامت دهان در بيماران مبتلا به مالتيپل اسكلروزيس

Evaluation of Oral Health-related Quality of Life in Patients with Multiple Sclerosis

ﻣﻘﺪﻣﻪ: ﻣﺎﻟﺘﯿﭙﻞ اﺳﮑﻠﺮوزﯾﺲ )MS( ﯾﮏ ﺑﯿﻤﺎري اﻟﺘﻬﺎﺑﯽ ﺗﺨﺮﯾﺐ ﮐﻨﻨﺪه ي ﻧﻮرون ﻫﺎ اﺳﺖ ﮐﻪ ﻋﻼوه ﺑﺮ ﻋﻮارض ﺟﺴﻤﯽ و رواﻧﯽ، ﺑﺮ ﺳﻼﻣﺖ دﻫﺎن اﺛﺮات ﻣﺨﺮب دارد. ﺑﺎ وﺟﻮد ﺑﺮرﺳﯽ ﻫﺎي ﺑﺴﯿﺎر در زﻣﯿﻨﻪ ي ﺳﻼﻣﺖ دﻫﺎن در ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ MS، ﺗﺎ ﺑﻪ ﺣﺎل ﻣﻄﺎﻟﻌﻪ اي ﺑﻪ ﺑﺮرﺳﯽ ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ واﺑﺴﺘﻪ ﺑﻪ ﺳﻼﻣﺖ دﻫﺎن در اﯾﻦ ﺑﯿﻤﺎران ﻧﭙﺮداﺧﺘﻪ اﺳﺖ. ﻫﺪف از اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺮرﺳﯽ ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ واﺑﺴﺘﻪ ﺑﻪ ﺳﻼﻣﺖ دﻫﺎن در ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ MS ﺑﻮد. ﻣﻮاد و روش ﻫﺎ: در ﻣﻄﺎﻟﻌﻪ ي ﻣﻮرد-ﺷﺎﻫﺪي ﺣﺎﺿﺮ، ﺗﻌﺪاد 103 ﺑﯿﻤﺎر ﻣﺒﺘﻼ ﺑﻪ MS و 103 ﻓﺮد ﺳﺎﻟﻢ ﺣﻀﻮر داﺷﺘﻨﺪ. اﻓﺮاد ﻫﺮ دو ﮔﺮوه ﭘﺮﺳﺸﻨﺎﻣﻪ ﻫﺎي اﺳﺘﺎﻧﺪارد ﺷﺪه )Oral Health Impact Profile (OHIP و ارزﺷﯿﺎﺑﯽ ﺷﺎﺧﺺ ﻫﺎي ﻣﺮﺗﺒﻂ ﺑﺎ رﻓﺘﺎر ﺳﻼﻣﺖ دﻫﺎن را ﺗﮑﻤﯿﻞ ﮐﺮدﻧﺪ. ﻫﻤﭽﻨﯿﻦ ﺷﺎﺧﺺ ﭘﻮﺳﯿﺪﮔﯽ ﺑﺮاي اﻓﺮاد ﻫﺮ دو ﮔﺮوه اﻧﺪازه ﮔﯿﺮي و ﺛﺒﺖ ﮔﺮدﯾﺪ. در ﻧﻬﺎﯾﺖ داده ﻫﺎ در ﻧﺮم اﻓﺰار SPSS ﺑﺎ اﺳﺘﻔﺎده از آزﻣﻮن ﻫﺎي Mann-Whitney و T-test و رﮔﺮﺳﯿﻮن ﺧﻄﯽ ﺑﯿﻦ ﻣﺘﻐﯿﺮ ﻫﺎ آﻧﺎﻟﯿﺰ ﺷﺪﻧﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ: ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ واﺑﺴﺘﻪ ﺑﻪ ﺳﻼﻣﺖ دﻫﺎن در ﮔﺮوه ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ MS از ﺟﻨﺒﻪ ي ﻣﺤﺪودﯾﺖ ﻋﻤﻠﮑﺮد از ﻧﻈﺮ آﻣﺎري ﺑﻄﻮر ﻣﻌﻨﯽ داري ﭘﺎﯾﯿﻦ ﺗﺮ از ﮔﺮوه ﺳﺎﻟﻢ ﺑﻮد )0/032=P(. ﻋﻼوه ﺑﺮ آن، ﻧﻤﺮه ي ﺷﺎﺧﺺ ﭘﻮﺳﯿﺪﮔﯽ در ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ MS ﺑﻄﻮر ﻣﻌﻨﯽ داري ﺑﺎﻻﺗﺮ ﺑﻮد )0/025=P(. ﻧﺘﯿﺠﻪ ﮔﯿﺮي: ﺑﻪ ﻧﻈﺮ ﻣﯽ رﺳﺪ ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ واﺑﺴﺘﻪ ﺑﻪ ﺳﻼﻣﺖ دﻫﺎن در ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ MS در ﻣﻘﺎﯾﺴﻪ ﺑﺎ اﻓﺮاد ﺳﺎﻟﻢ، ﻋﻠﯽ رﻏﻢ داﺷﺘﻦ ﭘﻮﺳﯿﺪﮔﯽ ﺑﯿﺸﺘﺮ، ﺗﻔﺎوت ﻣﻌﻨﯽ داري ﻧﺪارد. ﻣﻄﺎﻟﻌﺎت ﮐﯿﻔﯽ ﺑﻪ ﻣﻨﻈﻮر ﺑﯿﺎن ﺑﻬﺘﺮ ﻣﺸﮑﻼت ﺗﻮﺳﻂ اﯾﻦ ﺑﯿﻤﺎران در اﯾﻦ زﻣﯿﻨﻪ ﻧﯿﺎز اﺳﺖ.

Multiple sclerosis (MS) is an inflammatory disease that destroys neurons and exerts detrimental effects on oral health, apart from its negative physical and psychological consequences. Although there is a bulk of research on oral health in patients with MS, no study has evaluated the quality of life associated with oral health in these patients. Therefore, the current study aimed to assess oral health-related quality of life in patients with MS. Materials and Methods: This case-control study was conducted on 103 patients with MS and 103 healthy participants. The subjects in both groups completed standardized Oral Health Impact Profile (OHIP) questionnaires and assessments of indicators related to oral health behavior. Caries index was also measured and recorded for the subjects in both groups. Finally, the data were analyzed in SPSS software using linear regression, T-test, Mann-Whitney tests. Results: The oral health-related quality of life was statistically significantly lower in patients with MS, as compared to that in the control group (P=0.032). Moreover, the caries index score was significantly higher in patients with MS (P=0.025). Conclusion: As evidenced by the obtained results, oral health-related quality of life in patients with MS, who have more dental caries, is not significantly different from that in healthy individuals. Further qualitative studies are needed to shed more light on the problems posed to these patients