Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Gebelikte Ağız Sağlığıyla İlişkili Yaşam Kalitesinin Periodontal Durumla İlişkisi
The Relationship Between Periodontal Status and Oral Health-Related Quality of Life in Pregnancy
Özge GÖKTÜRKa, Fatma UÇAN YARKAÇb
aPeriodontoloji AD, Abant İzzet Baysal Üniversitesi Diş Hekimliği Fakültesi, Bolu, TÜRKİYE
bPeriodontoloji AD, Gaziosmanpaşa Üniveristesi Diş Hekimliği Fakültesi, Tokat, TÜRKİYE
Turkiye Klinikleri J Dental Sci. 2019;25(1):34-42
doi: 10.5336/dentalsci.2018-61789
Article Language: TR
Full Text
ÖZET
Amaç: Gebe olan ve olmayan jinjivitli kadınlar arasında ağız sağlığı ile ilgili yaşam kalitesi (OHRQoL) açısından fark olup olmadığı araştırmak ve gruplar arasında cerrahi olmayan periodontal tedavinin yaşam kalitesi üzerine etkisini değerlendirmektir. Gereç ve Yöntemler: Bu çalışmaya test grubu olarak 50 gebe kadın (ortalama yaş 28,78±3,69 yıl) ve kontrol grubu olarak 42 gebe olmayan kadın (ortalama yaş 27,59±5,66 yıl) dâhil edildi. Bireyin algılanan OHRQoL'sini belirlemek için Ağız Sağlığı Etki Profili-14 (OHIP-14) anketi kullanıldı. Periodontal durumunu belirlemek için jinjival indeks (Gİ), plak indeksi (Pİ), sondalama cep derinliği (SCD) ve sondalamada kanama indeksi (SKİ) ölçümleri yapılmıştır. Bulgular: Gebelik jinjiviti olan kadınlar (test grubu) için toplam OHIP skoru 18,46±15,82, gebe olmayan jinjivitli kadınların (kontrol grubu) toplam OHIP skoru 14,14±7,94'dür. Test ve kontrol grubu arasında istatistiki anlamlı fark yoktur. 'Fiziksel yetersizlik' alt grubunda gebe olan ve olmayan kadınlar arasında istatistiki anlamlı fark vardı. Test grubu için ortalama SCD ve Gİ kontrol grubundan anlamlı derecede daha yüksek bulundu. Periodontal tedaviden sonra iki grupta da OHRQoL skorlarında düşüş gözlendi. Sonuç: Gebelik jinjiviti olan kadınlarda periodontal sağlık, gebe olmayan jinjivitli kadınlardan daha zayıftı. Jinjivit, ağız sağlığına bağlı yaşam kalitesi üzerine etkilidir. Daha yüksek puanlar, daha düşük bir OHRQoL olduğunu göstermektedir. Ağız sağlığı ile ilişkili yaşam kalitesinin artırılabilmesine yönelik olarak, gebelik döneminden önce ve gebelik döneminde düzenli yapılan diş hekimi kontrolleri ile atravmatik ve etkili tedavi uygulamalarıyla periodontal durumun, dolayısıyla ağız sağlığının iyileştirilmesi gerekli görülmektedir.

Anahtar Kelimeler: Gebelik; periodontal hastalıklar; yaşam kalitesi
ABSTRACT
Objective: The aim of this study is to assess the differences in oral health-related quality of life (OHRQoL)between pregnant and non-pregnant women with gingivitis and to evaluate the effect of non-surgical periodontal treatment on quality of life in all groups. Material and Methods: This study included 50 pregnant women (mean age 28.78±3.69) and 42 non-pregnant women (mean age 27.59±5.66). The Oral Health Impact Profile-14 (OHIP-14) questionnaire was used to determine the OHRQoL of the individuals. Periodontal status was defined using gingival index (GI), plaque index (PI), probing pocket depth (PPD) and bleeding on probing (BOP) measurements. Results: The total OHIP-14 scores for pregnant women with pregnancy ingivitis (test group) were 18.46±15.82 and non-pregnant women with gingivitis were 14.14±7.94. There was no significant difference between groups. There was a statistically difference between the test and control groups in the 'physical disability' subgroup. The mean PPD and GI scores were significantly higher in the test group than control group. There was a decrease in OHRQoL scores in both groups after periodontal treatment. Conclusion: Periodontal status of women with pregnancy gingivitis was poor than non-pregnant women with gingivitis. Gingivitis effects on the oral health-related quality of life. High OHIP-14 scores indicate the low oral health-related quality of life. To increase the OHRQoL, periodontal status and oral health should be improved by regular dental visits, atraumatic treatment applications before and during pregnancy.

Keywords: Pregnancy; periodontal diseases; quality of life
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www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

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