title: Are periodontal diseases really silent? A systematic review of their effect on quality of life.
abstract: OBJECTIVE
  Periodontal diseases (PDs) may play an important role in the effect oral health status has on a person's quality of life (QoL). The objective was to investigate the influence of PDs (gingivitis and periodontitis) on oral health-related QoL (OHRQoL) by systematically reviewing the literature.
  
  
  METHODS
  Studies using clinical periodontal examinations and validated survey instruments were included. Among 1134 citations initially identified through electronic and hand searching, 37 were eligible and data were extracted from full texts. A vote counting method was used for synthesis of the results.
  
  
  RESULTS
  Included studies were published between 2001 and 2014 and revealed considerable heterogeneity in participant selection, clinical assessments, and OHRQoL measures. A significant association between PDs and OHRQoL was reported in 28 studies, of which eight reported increasing impact with greater disease severity or extent.
  
  
  CONCLUSIONS
  Within the limits of the available literature, OHRQoL was affected by clinically assessed PDs. There was evidence for increased impairment with greater severity and extent of PDs, and the recognition of the association was increased when full mouth recording protocols were applied.
authors.affiliation: Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Basel, Switzerland.
authors.forename: Sabrina Lill
authors.initials: SL
authors.lastname: Buset
authors.affiliation: Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Basel, Switzerland.
authors.forename: Clemens
authors.initials: C
authors.lastname: Walter
authors.affiliation: Clinic for Periodontology, University of Witten, Witten, Germany.
authors.forename: Anton
authors.initials: A
authors.lastname: Friedmann
authors.affiliation: Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Basel, Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: Weiger
authors.affiliation: Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
authors.forename: Wenche S
authors.identifier: http://orcid.org/0000-0003-3593-093X
authors.initials: WS
authors.lastname: Borgnakke
authors.affiliation: Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Basel, Switzerland.
authors.forename: Nicola U
authors.initials: NU
authors.lastname: Zitzmann
mesh_terms: D005891:Gingivitis; D006801:Humans; D009909:Oral Health; D010510:Periodontal Diseases; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: clinical assessment; diagnosis; gingivitis; oral; oral health; periodontal index; periodontitis; quality of life; questionnaires; self-report