Food intake, masticatory function, tooth mobility, loss of posterior support, and diminished quality of life are associated with more advanced periodontitis stage diagnosis

AIM: To describe periodontal and functional characteristics of subjects diagnosed with different stages of periodontitis and to associate measures of masticatory function and quality of life with periodontitis stage. MATERIALS AND METHODS: This was a cross-sectional study on a convenience sample of 214 subjects with periodontitis seeking oral care in a hospital setting. They received a full-mouth intra-oral examination including dental and periodontal charting by a single calibrated examiner who also established the periodontitis stage diagnosis. Subjects were assessed using the OHIP-14, a validated masticatory dysfunction questionnaire, and a quantitative test based on the ability to mix a dual colour chewing gum. Mixing was quantified based on the variance of hue (VOH) with a colorimetric software. Descriptive, univariate, and multivariate analyses were performed. RESULTS: Subjects with stage IV periodontitis reported greater impairment of oral-health-related quality of life, reduced food intake or altered food type intake attributed to difficulties in chewing, objective measures of masticatory dysfunction, tooth loss, as well as more advanced periodontal breakdown compared with subjects with stages I-III of the disease. Quantitative assessment of masticatory function was associated, in a multivariate analysis, with (i) loss of functional tooth units in the premolar/molar region, presence of hypermobile teeth, and severity of periodontal attachment loss, and (ii) age, body mass index, and periodontitis stage IV and grade C diagnosis. CONCLUSIONS: Subjects with stage IV periodontitis are characterized by a specific set of signs and symptoms of advanced periodontal breakdown and functional impairment, which impact on the quality of life and masticatory function/food intake choices. Stage IV periodontitis captures a clinical entity with distinct features and treatment needs. This study is registered in ClinicalTrials.gov (NCT03928080).