title: Periodontal Status and Quality of Life: Impact of Fear of Pain and Dental Fear.
abstract: Background. Oral health-related quality of life (OHRQoL) is impacted by periodontal disease and orofacial pain. There is a limited research examining the impact of avoidance of care or physiological arousal related to the fear of pain response on periodontal-related OHRQoL.Methods. Data are from the Center for Oral Health Research in Appalachia family-based study focusing on 1,339 adults. Measures included a modified Periodontal Screening and Recording Index across sextants of dentition, dental fear survey, Fear of Pain Questionnaire-9, and Oral Health Impact Profile-14. Structural equation modeling was used to estimate the effects of periodontal disease screening indicators on OHRQoL including the mediating role of dental fear while accounting for fear of pain.Results. A significant total effect was found for the mandibular anterior sextant, components of dental anxiety/fear, and indicators of OHRQoL (pain and discomfort,β= .165,p= .001; psychosocial impact,β= .199,p< .001). The maxillary anterior region was significantly associated with pain discomfort (β= .116,p= .017) and functionality (β= .130,p= .011).Conclusions. Findings provide a granular perspective of periodontal disease indicators and OHRQoL. Dental avoidance/anticipatory fear and physiological arousal mediate OHRQoL in individuals who have indicators of periodontal disease in sextants that may be visible and susceptible to higher pain and psychosocial impact.
authors.affiliation: Department of Psychology, West Virginia University, 53 Campus Drive, P.O. Box 6040, Morgantown, WV 26506, USA; Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA; Department of Dental Practice & Rural Health, Center for Oral Health Research in Appalachia (COHRA), School of Dentistry, West Virginia University, One Medical Center Drive, Morgantown, WV 26506, USA.
authors.forename: Casey D
authors.identifier: 0000-0003-1189-5877
authors.initials: CD
authors.lastname: Wright
authors.affiliation: Department of Psychology, West Virginia University, 53 Campus Drive, P.O. Box 6040, Morgantown, WV 26506, USA; Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA; Department of Dental Practice & Rural Health, Center for Oral Health Research in Appalachia (COHRA), School of Dentistry, West Virginia University, One Medical Center Drive, Morgantown, WV 26506, USA.
authors.forename: Daniel W
authors.identifier: 0000-0002-0766-8455
authors.initials: DW
authors.lastname: McNeil
authors.affiliation: Department of Psychology, West Virginia University, 53 Campus Drive, P.O. Box 6040, Morgantown, WV 26506, USA; Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA; Department of Dental Practice & Rural Health, Center for Oral Health Research in Appalachia (COHRA), School of Dentistry, West Virginia University, One Medical Center Drive, Morgantown, WV 26506, USA.
authors.forename: Cierra B
authors.identifier: 0000-0002-5526-4543
authors.initials: CB
authors.lastname: Edwards
authors.affiliation: Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA; Department of Periodontics, Center for Oral Health Research in Appalachia (COHRA), School of Dentistry, West Virginia University, One Medical Center Drive, Morgantown, WV 26506, USA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Crout
authors.affiliation: Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA; Department of Oral Biology, Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Bridgeside Point Suite 500, 100 Technology Drive, Pittsburgh, PA 15219, USA.
authors.forename: Katherine
authors.identifier: 0000-0002-1250-6813
authors.initials: K
authors.lastname: Neiswanger
authors.affiliation: Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA; Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA 15261, USA.
authors.forename: John R
authors.identifier: 0000-0003-1897-1131
authors.initials: JR
authors.lastname: Shaffer
authors.affiliation: Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA; Department of Oral Biology, Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Bridgeside Point Suite 500, 100 Technology Drive, Pittsburgh, PA 15219, USA; Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA 15261, USA.
authors.forename: Mary L
authors.identifier: 0000-0002-2648-2832
authors.initials: ML
authors.lastname: Marazita
mesh_terms: D000328:Adult; D055113:Chronic Periodontitis / Q000175:diagnosis / Q000503:physiopathology*; D016854:Dental Anxiety; D003729:Dental Care; D005163:Factor Analysis, Statistical; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009909:Oral Health; D010146:Pain / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult