Impact of preoperative anxiety on postoperative quality of life after free gingival graft surgery: a prospective cohort clinical study

Aims: This study aimed to evaluate the effect of free gingival graft (FGG) surgery on patients’ oral health-related quality of life (OHQoL) during early healing and to assess the influence of preoperative anxiety over a one-month follow-up. Methods: A total of 36 patients (11 males, 25 females) were enrolled. OHQoL was assessed using OHIP-14 at baseline (T0), during the first postoperative week (T1-7), and at 1 month (T30). Demographic variables and smoking status were recorded. Preoperative anxiety was evaluated using STAI-S/T, and postoperative pain during T1-7 was assessed using VAS. Intraoperative graft and recipient site dimensions were recorded. Plaque and gingival index and keratinized tissue width were assessed at T0 and T30. Results: Total OHIP-14 scores increased significantly during T1-3 and decreased significantly at T30 compared with T0 (p<0.05). Functional limitation scores increased during T1-7, pain and discomfort during T1-2, and behavioral impact on T1, while psychological impact scores showed significant improvement during T6-7. Analgesic consumption on T1 was positively correlated with total OHIP-14 scores. Females demonstrated higher OHIP-14 scores at T0 and throughout T1-7, whereas smokers exhibited higher scores during T3-7. STAI-S scores were significantly higher in females and showed significant correlations with OHIP-14 total and pain-discomfort scores at T0 and T3-7 (p<0.05). STAI-T correlated significantly with OHIP-14 only at T7. Conclusion: FGG surgery was associated with short-term OHQoL impairment, with recovery at one month; associations with anxiety, gender, and smoking should be interpreted cautiously.