Smoking, general and oral health related quality of life – a comparative study from Nepal

BACKGROUND: Perceived dental health has shown to have a significant predictive effect on overall health perception and life satisfaction. Thus, it seems plausible that Health Related Quality of Life (HRQOL) measures are associated with Oral Health Related Quality of Life (OHRQOL) dimensions in Nepalese context as well. The adverse effects of tobacco on oral health are reported worldwide including Nepal. However, evidence which can quantify effects of tobacco smoking on dental health perception is limited. Thus, a study was designed to find association of smoking and socio demographic characteristics with OHRQOl and to determine association between OHRQOL and HRQOL among dental patients in Nepal. METHODS: A cross sectional study was conducted among 125 current smokers and 125 non-smokers who attended oral surgery OPD of a teaching hospital in Kathmandu, Nepal. The study participants were enrolled through consecutive sampling and data was collected through a semi-structured questionnaire. The questionnaire consisted of questions related to sociodemographic characteristics, tobacco history, Oral Health Impacts Profile (OHIP)-14 and World Health Organization Quality of Life Brief version (WHOQOL-Bref) to assess OHRQOl and HRQOL respectively. Descriptive and inferential statistics were calculated by using SPSS version 18.0. The level of significance was set at 5%. RESULTS: Among the socio demographic characteristics, patients with education of more than Class 12 had significantly higher average OHRQOL scores (p = 0.013) compared to illiterate patients. Current smokers reported significantly poorer scores in sub scales of psychological disability (p = 0.001), social disability (p = 0.003), physical pain (p < 0.001), functional limitation (p = 0.007) and also overall perceived oral health compared to nonsmokers. OHRQOL was significantly correlated with overall HRQOL in physical (p = 0.015) and psychological (p = 0.04) domains in this study sample. CONCLUSIONS: Improvements in OHRQOL may require a multidimensional approach with focus of social factors like education and behavioral factors like cigarette smoking. Also, improvement in OHRQOL might also lead to betterment of perceived overall health as they are interlinked.