Impact of socioeconomic inequalities on quality of life in oral submucous fibrosis patients

Non-specific Chief Complaints Among Oral Submucous Fibrosis Patients at Outpatient Department and Pan Shop at Rural Region in India

Aim:

The first communication with a healthcare professional is critical for determining the correct diagnosis, particularly when it comes to patients’ description of symptoms. This study aimed at exploring the primary symptoms observed in oral submucous fibrosis patients with non-specific complaints visiting outpatient department and pan shop at Kanpur, India.

Materials and Methods:

It was a cross-sectional study involving a two-stage sampling to select clinically diagnosed oral submucous fibrosis (OSF) patients from the outpatient department and pan shop customers (PSCs) at rural healthcare centers. A total of 321 participants were selected based on convenience sampling. Patient demographics, history of relevant habits with a period, and socioeconomic status were all documented. The extent of mouth opening was used to grade OSF cases. Data were analyzed using MedCalc Version 19.7.2 with χ², Wilcoxon signed-rank, and t-tests used, as appropriate, to calculate P-values.

Results:

Out of the 184 OSF-OPD patients, only 59 (32.06%) described relevant disease symptoms of OSF: in stage III, 28.5% or stage IV, 38.7%. One hundred and twenty-five patients (67.93%) reported chief complaints (CCs) unrelated to OSF, and all of these cases were diagnosed with an early stage of OSF (stage I: 72.41% and stage II: 61.53%). Out of the total 137 PSCs, 74 PSCs have had prior dental consultations, but only 44 (32.11%) people had sought medical help because of OSF-related CCs.

Conclusion:

A limited number of studies were conducted in this area, particularly in the rural population of central India. Our study found that considerable amount of main complaints from OSF patients was unrelated to their symptoms. There is insufficient knowledge of OSF symptoms among rural population, which further restricts early detection of the disease.

Quality of Life in Oral Submucous Fibrosis- A Case Report with a Literature Review

Introduction:

Oral Submucous Fibrosis (OSMF) is a potentially malignant disorder commonly found in the Southeast Asian region, classically characterized through restricted mouth opening and burning sensation in the mouth on consuming spicy food. The etiopathogenesis and treatment aspects of OSMF have been extensively researched and reviewed. However, the effect of this condition on the Quality of Life (QoL) of patients has not gained much consideration. The aim of our case report is to highlight the importance of evaluating the QoL in an OSMF patient by using discipline-specific questionnaire and also to present to the readers a review of the recently published research articles on the application of QoL questionnaires in OSMF patients.

Results:

It was observed that most of the researchers used generic and discipline-specific questionnaire for evaluating the quality of life in OSMF patients.

Conclusion:

Evaluation of QoL is recommended during the treatment of OSMF patients. There is a need to develop and employ more of disease-specific QoL instruments for OSMF patients.

Treatment outcomes of laser therapy in oral submucous fibrosis-a systematic review

Background

The mainstay of oral submucous fibrosis (OSF) management is to increase the mouth opening; thereby improving oral functionalities. In modernized dentistry, laser therapy (LT) could play a major role for trismus relief in OSF patients. The present review was performed to systematically analyze the published literature on LT for OSF management.

Methods

PubMed, Scopus, Web of Science and CINAHL databases were searched until June 2019 using suitable key words and the information was extracted according to the PRISMA guidelines. All full text papers that assessed efficacy of LT for OSF management without limitations on age, gender, ethnicity, or socioeconomic status of the participants were considered eligible. Participants were allocated to the LT alone or in adjunct to oral physiotherapy and medicinal treatment. Outcome parameters included the reduction in trismus. Review articles, case reports, editorial, conference abstracts and in vitro studies were excluded. No restriction was applied on date and language of the publications.

Results

Out of 97 published papers, 7 studies met the inclusion criteria and were included for the analysis. All the studies were clinical and mainly included stage II and III OSF patients. Although different laser types and other parameters were used, all the studies reported improvement in mouth opening in the range of 6.84 mm and 23.7 mm. Additionally, two studies noticed reduced burning sensation and increased tongue protrusion and cheek flexibility. Conclusion: The LT can provide a promising and better means for relieving trismus and probably OSF-related other symptoms in moderate stages of the disease.

Patients with oral submucous fibrosis who visit dental hospitals have nonspecific chief complaints

Background:

The first consultation with a health-care professional is crucial to make the correct diagnosis particularly with respect to narrating the symptoms encountered by the patient. Yet, currently, no information is available concerning the primary symptoms documented by patients with oral submucous fibrosis (OSF).

Materials and Methods:

A total of 158 OSF patients visiting outdoor patient departments (OSF-OPDs) and 104 pan shop customers (PSCs) were investigated. OSF-OPD cases and relevant PSCs cases were investigated to discover the chief complaints (CCs) leading to dental visits. Detailed demographic data, patient histories concerning relevant habits (with duration), and socioeconomic status were recorded. OSF cases were graded based on the degree of mouth opening.

Results:

Out of 158 OSF-OPD patients, only 43 (26.58%) reported relevant disease symptoms of OSF: in stage III, 28.57%, or stage IV, 38.09%. One hundred and sixteen patients (73.41%) reported CCs unrelated to OSF, and all of these cases were diagnosed with an early stage of OSF (stage I: 47.05% and stage II: 22.5%). Out of the total 104 PSCs, 66 PSCs have had prior dental consultations, but only five (4.80%) individuals had visited a health-care professional due to OSF-related CCs.

Conclusion:

A significant number of CCs made by OSF patients were unrelated to their disease signs and symptoms. There is a lack of awareness of OSF symptoms by pan chewers, thus hindering early detection.

Assessment of oral health-related quality of life instruments for oral submucous fibrosis: A systematic review using the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist

Quality of life (QoL) instruments are becoming increasingly important in research and often used in clinical practice. Various QoL instruments have been developed/ validated for assessment of oral health-related QoL (OHRQoL) in patients with oral submucous fibrosis (OSF). Selection of an adequate instrument is challenging in routine practice due to lack of information on psychometric quality of measurement instruments. This systematic review gives an extensive overview of quality of all the currently available measurement instruments for use in OSF patients. PubMed, Scopus, Web of Science and CINAHL were searched for relevant literature until December 2018 and the information was extracted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the identified studies was assessed per measurement property according to the COnsensus-based Standards for the selection of health Measurements Instruments (COSMIN) checklist. Four studies that met the inclusion criteria were included. Three generic and one disease-specific QoL instruments were identified. Information regarding important measurement properties was often incomplete. The evidence for the quality of measurement instruments was found to be variable, none of the instruments performed sufficient on all measurement properties. Based on the available information, OHRQoL-OSF appeared to have adequate COSMIN measurement properties. As recently published, newer QoL instruments have not yet been evaluated in an adequate manner for use in OSF. We suggest future studies should implement OSF-specific OHRQoL-OSF to better understand OSF patients' perspectives and help inform clinicians to propose treatment strategies as per patients' needs.