Oral health-related quality of life: an emotional subject?
MedWire News: People who have difficulties in regulating their emotions also suffer from worse oral health-related quality of life (OHRQoL), Finnish research shows.
Alexithymia is a disorder where people have problems regulating their emotions and is associated with difficulties in identifying feelings, and distinguishing between feelings and bodily sensations.
This disorder is associated with poorer HRQoL in the general population and in those with systemic diseases. However, little is known of the effects of alexithymia on OHRQoL.
In the present study, Aino Mattila (University of Tampere, Finland) and colleagues investigated the association between alexithymia and OHRQoL in a sample of 4460 individuals from the general Finnish population.
OHRQoL was measured using the 14-item Oral Health Impact Profile (OHIP-14). Alexithymia was measured using the 20-item Toronto Alexithymia Scale (TAS-20), which consists of three dimensions: difficulties in identifying feelings (DIF), difficulties in describing feelings (DDF), and externally oriented thinking (EOT).
Associations between OHRQoL and the TAS-20 were investigated using regression analyses.
At baseline, higher (worse) scores in the majority of OHIP-14 dimensions were associated with male gender, living alone, and the presence of depression or anxiety.
Upon analysis, older age, higher TAS-20 score, as well as higher DIF, DDF, and EOT scores, were statistically significantly associated with poorer OHRQoL as measured by the OHIP-14.
In unadjusted analyses, all of the associations between OHIP-14 and TAS-20 variables were statistically significant, including those of the three TAS-20 dimensions. Odds ratios (ORs) for the associations ranged between 1.4 and 1.9.
Once analyses had been adjusted for dental health, depression, anxiety, and sociodemographic variables, all associations were still significant with the exception of the EOT dimension; ORs ranged from 1.2 to 1.8.
Writing in European Journal of Oral Sciences, Mattila and team say that "in a large population sample with a wide age-range and controlling for essential confounders, those with higher levels of alexithymia were more likely to have poorer outcome on all dimensions of the OHRQoL measure OHIP-14."
They conclude that "it is possible that poorer OHRQoL may be associated with difficulties in emotional processing rather than explicitly with objective oral health problems.
"People with strong alexithymic features may benefit from the caregivers' understanding of the special difficulties they have in dealing with their emotions and oral health problems."
By Iain Bartlett