Will periodontal treatment really make me feel better?

PD Dr. Kristina Bertl, PhD MSc MBA

From the patient’s point of view in particular, having treatment for periodontal disease can seem tedious and stressful. Patients find one fact hard to deal with in particular: periodontal disease is a chronic condition that requires a life-time follow-up (every 3 months in severe cases) to ensure the patient’s periodontal status remains stable after the active phase of treatment and during maintenance therapy. Inevitably we are asked the following question again and again: ‘will periodontal treatment really make me feel better?’

To determine whether patients really ‘feel better’ after treatment, most studies draw on the concept of oral-health-related quality of life. Patients can be questioned about this quite easily by means of a standardized questionnaire (Oral Health Impact Profile – OHIP). Data from a systematic review (Shanbhag et al. 2012) of 11 original studies on this topic show that:

1. Before periodontitis patients undergo periodontal treatment, their oral-health-related quality of life is negatively affected by the disease.
2. Non-surgical periodontal treatment leads to a significant improvement in oral-health-related quality of life.
3. The improvement in oral-health-related quality of life correlates with the treatment outcome; this means that if the desired treatment effect is not achieved, the improvement in oral-health-related quality of life is smaller.

The improvement in oral-health-related quality of life after periodontal treatment also appears to be long-lasting. A German research group recently published 20-year data on this topic (El Sayed et al. 2019). Based on 63 patients with chronic periodontitis, the authors showed that oral-health-related quality of life is generally very high 20 years after the active phase of treatment has finished; however, certain limitations remain with regard to function, for example. High compliance and smoking cessation had a positive impact.

Our answer to the above question should therefore clearly be: ‘yes, and for the long term!’

Reference

1. El Sayed N, Baeumer A, El Sayed S, et al. Twenty years later: Oral health-related quality of life and standard of treatment in patients with chronic periodontitis. J Periodontol. 2019;90:323–330. Shanbhag S, Dahiya M, Croucher R. The impact of periodontal therapy on oral health-related quality of life in adults: a systematic review. J Clin Periodontol 2012; 39: 725–735. doi: 10.1111/j.1600-051X.2012.01910.x.