مجله دانشکده دندان‌پزشکی اصفهان

بررسی کیفیت زندگی مرتبط با سلامت دهان و سلامت روان در بیماران مبتلا به اختلال مفصل گیجگاهی- فکی

نوع مقاله : مقاله‌های پژوهشی

چکیده

مقدمه: اختلال مفصل گیجگاهی- فکی TMD (Temporomandibular joint disorder)، تأثیر بسزایی بر رفتارهای اجتماعی و حالات روانی بیماران دارد و بر کیفیت زندگی وابسته به سلامت دهان، تأثیرگذار است. هدف از مطالعه‌ی حاضر، تعیین ارتباط اختلال مفصل گیجگاهی- فکی با کیفیت زندگی وابسته به سلامت دهان و سلامت روان بود.
مواد و روش‌ها: در این مطالعه‌ی توصیفی- تحلیلی، از بین بیماران مبتلا به TMD که در سال 1395-1396 به دانشکده‌ی دندان‌پزشکی دانشگاه آزاد اسلامی واحد اصفهان (خوراسگان) مراجعه کرده بودند، تعداد 75 بیمار به عنوان گروه مورد و 75 نفر با همان شرایط و بدون تشخیص بیماری‌ به عنوان گروه شاهد، انتخاب شدند. برای بررسی سلامت دهان، از پرسش‌نامه‌ی اختصاصی سلامت دهانی (Oral Health Impact Profile :OHIP14) و برای بررسی سلامت روانی، از پرسش‌نامه‌ی سلامت‌ عمومی (GHQ-28: General Health Questionnaire) و برای درجه‌بندی درد مزمن، از پرسش‌نامه‌ی RDC/TMD Axisll (Research Diagnostic Criteria for Temporomandibular Disorders) استفاده شد. داده‌ها توسط آزمون‌های آماری رگرسیون، ANOVA و کروسکال- والیس تجزیه و تحلیل شدند (α = 0/05).
یافته‌ها: شاخص کیفیت زندگی وابسته به سلامت دهان OHIP14 (شیوع، شدت و گستردگی) بین دو گروه بیمار و شاهد، تفاوت معنی‌دار داشتند (p value = 0/0001) و در بین زنان بیمار، بیشتر از مردان بود و با بالا رفتن شدت درد مزمن، وضعیت شاخص بدتر می‌شد. شاخص‌های سلامت روان GHQ-28 (جسمانی‌سازی، اضطراب، افسردگی و اختلال روانی) بین دو گروه بیمار و شاهد، تفاوت معنی‌دار داشتند (p value = 0/0001) و با بالا رفتن شدت درد مزمن، وضعیت سلامت روان بدتر می‌شد. در بررسی ارتباط بین کیفیت زندگی وابسته به سلامت دهان (OHIP14) و سلامت روان (GHQ-28)، بیمارانی که در شاخص‌های GHQ-28 دارای اختلال بودند، از سلامت دهانی پایین‌تری برخوردار بودند (p value < 0/05).
نتیجه‌گیری: اختلال مفصل گیجگاهی- فکی، بصورت منفی، کیفیت زندگی وابسته به سلامت دهان و سلامت روان را تحت تأثیر قرار می‌دهد. در بیماران TMD، سلامت روان و سلامت دهان ارتباط نزدیکی باهم دارند، بطوری که بیماران با اختلال روانی، شاخص سلامت دهان و دندان OHRQOL (Oral Health Related Quality of Life) پایین‌تری نیز داشتند.
کلید واژه‌ها: کیفیت زندگی، سلامت روان، سلامت دهان، اختلالات مفصل گیجگاهی- فکی

عنوان مقاله [English]

Evaluation of Oral Health and Psychological Health Related Quality of Life in Patient with Temporomandibular Disorders

چکیده [English]

Introduction: Temporomandibular joint disorder (TMD) has a significant effect on the sufferer’s social behavior, mental state and oral health-related quality of life. The aim of this study was to evaluate the relationship between TMD and oral health-related quality of life and mental health.
Materials and Methods: In this analytical‒descriptive study, of patients with TMD, who referred to Dental School of Khorasgan University in 2016‒2017, 75 patients with TMD were selected for the case group, while 75 patients with the same conditions but without a TMD diagnosis were selected for the control group. The OHIP14 (Oral Health Impact Profile) questionnaire was used to evaluate each patient’s oral health and GHQ-28 (General Health Questionnaire) was used to evaluate mental health. Chronic pain was graded with RDC/TMD Axis11 (Research Diagnostic Criteria for Temporomandibular Disorders) questionnaire. Data were analyzed with regression analysis, ANOVA and Kruskal-Wallis test, using SPSS 22 (α = 0.05).
Results: OHIP14 indicators (prevalence, intensity and popularity) were significantly different between the case and control groups (p value < 0.0001). These scores were higher in female TMD patients compared to males and were higher in patients with high levels of chronic pain. GHQ-28 mental health indicators (materializing, stress, depression and mental issues) were significantly different between the two groups (p value < 0.0001). An increase in pain severity resulted in deterioration of mental health. Analysis of the relationship between mental health (GHQ-28) and oral health (OHIP14) revealed that patients with lower GHQ-28 scores had lower levels of oral health (p value < 0.05).
Conclusion: TMD negatively affects oral health-related quality of life and mental health. Mental health and oral health levels are highly correlated in TMD patients; patients with mental health issues often score low in OHRQoL. 
Key words: Mental health, Oral health, Quality of life, Temporomandibular joint disorders

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مجله دانشکده دندان‌پزشکی اصفهان
دوره 15، شماره 2 - شماره پیاپی 2
اردیبهشت 1398
صفحه 138-147