The Canadian systemic sclerosis oral health study II: the relationship between oral and global health-related quality of life in systemic sclerosis

Rheumatology (Oxford). 2015 Apr;54(4):692-6. doi: 10.1093/rheumatology/keu396. Epub 2014 Oct 6.


Objective: Both oral and global health-related quality of life (HRQoL) are markedly impaired in SSc. In this study we aimed to determine the degree of association between oral HRQoL and global HRQoL in SSc.

Methods: Subjects were recruited from the Canadian Scleroderma Research Group registry. Global HRQoL was measured using the Medical Outcomes Trust 36-item Short Form Health Survey (SF-36) and oral HRQoL with the Oral Health Impact Profile (OHIP). The Medsger Disease Severity Score was used to determine organ involvement. Multivariate regression models determined the independent association of the OHIP with the SF-36 after adjusting for confounders.

Results: This study included 156 SSc subjects. The majority (90%) were women, with a mean age of 56 years, mean disease duration 13.8 years (s.d. 8.5) and 29% of the subjects had dcSSc. Mean total OHIP score was 40.8 (s.d. 32.4). Mean SF-36 mental component summary (MCS) score was 49.7 (s.d. 11.1) and physical component summary (PCS) score was 37.0 (s.d. 10.7). In adjusted analyses, the total OHIP score was significantly associated with the SF-36 MCS and PCS, accounting for 9.7% and 5.6% of their respective variances. Measures of disease severity were not related to OHIP score.

Conclusion: Oral HRQoL in SSc is independently associated with global HRQoL. Oral HRQoL, however, is not related to physician-assessed disease severity. This suggests that physicians may be disregarding issues related to oral health. HRQoL is an additional dimension of HRQoL not captured by generic instruments such as the SF-36.

Keywords: oral health; oral hygiene; oral pathology; quality of life; questionnaires; systemic scleroderma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Canada
  • Cross-Sectional Studies
  • Female
  • Health Status*
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Oral Health*
  • Quality of Life*
  • Scleroderma, Systemic / physiopathology*
  • Severity of Illness Index
  • Surveys and Questionnaires