Periodontal maintenance: individual patient responses and discontinuations

Christian Graetz; Johannes C Ehrenthal; Rebecca Kowalski; Miriam Cyris; Antje Geiken; Christoph E Dörfer

doi:10.1186/s12903-022-02655-8

Periodontal maintenance: individual patient responses and discontinuations

BMC Oral Health. 2022 Dec 15;22(1):610. doi: 10.1186/s12903-022-02655-8.

Authors

Christian Graetz^#¹, Johannes C Ehrenthal^#², Rebecca Kowalski³, Miriam Cyris³, Antje Geiken³, Christoph E Dörfer³

Affiliations

¹ Clinic for Conservative Dentistry and Periodontology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany. graetz@konspar.uni-kiel.de.
² Department of Psychology, University of Cologne, Cologne, Germany.
³ Clinic for Conservative Dentistry and Periodontology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.

^# Contributed equally.

Abstract

Aim: There is a lack of data on long-term impact of different psychological variables on periodontitis. Aim of the current study was to investigate the impact of psychological factors in patients with chronic periodontitis (CP; according to the 1999 Classification of Periodontal Diseases) to explain adherence to or discontinuation of supportive periodontal therapy (SPT) in a university setting.

Methods: A sample of n = 119 patients were examined in a questionnaire-based, cross-sectional survey. All patients had received active periodontal treatment (APT) and were reevaluated in a university setting (Kiel) before 2016 [T1: start SPT]. Patients who showed sufficient adherence to SPT of ≥ 2 years (maximum ± 6 months of deviation between SPT intervals, last visit and questionnaire at T2) were assigned to the adherence group (AG: n = 58), or, if they interrupted SPT or stopped treatment altogether, to the non-adherence group (NAG: n = 61). In addition to dental parameters, we assessed socio-demographic, treatment-related (critical attitudes/complaints), dental as well as psychological variables (especially psychological attachment, but also dental fear, patient participation style, personality functioning) and examined between-group differences as well as possible mediating factors of non-adherence to treatment continuation.

Results: For both groups we found similar average observation time (NAG/AG: 15.9(8.9)/14.9(10.6)years). There were significant differences in age, critical attitudes, dental fear, and patient participation style between the groups. With the help of exploratory sequential mediation models, we found a significant indirect pathway of the impact of attachment anxiety on discontinuation of treatment mediated through dental fear and number of critical attitudes/complaints.

Conclusion: Considering the limitations, dentists should be aware of personality-related risk-factors such as attachment anxiety as well as their interplay with levels of dental fear and critical attitudes which may influence adherence to SPT.

Trial registration: The clinical trial was retrospectively registered in the DRKS-German Clinical Trials Register ( https://www.drks.de ) with registration DRKS00030092 (26/08/2022).

Keywords: Adult attachment; Compliance; Dental fear; Periodontitis; Supportive periodontal therapy; Tooth loss.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Chronic Periodontitis* / therapy
Cross-Sectional Studies
Humans
Periodontal Pocket / therapy
Retrospective Studies
Tooth Loss*
Treatment Outcome

Associated data

DRKS/DRKS00030092