Abstract
BACKGROUND: Aim of this questionnaire-based cross-sectional study was to compare self-efficacy, social support, oral hygiene-related self-efficacy (OHRSE) and oral health-related quality of life (OHRQoL) between patients under chronic hemodialysis (HD) and patients after kidney transplantation (KTx) as well as a healthy comparison group (HC). METHODS: Patients under HD were recruited during their routine outpatient dialysis therapy, KTx patients during their maintenance appointment and HC patients during their regular dental check-up in the dental clinic. General self-efficacy, the OHRSE, social support (F-SozU-K14) and the OHRQoL (OHIP-G5) were assessed by specific validated questionnaires. The survey was performed by one experienced dentist. RESULTS: 44 HD, 40 KTx and 45 HC patients were included, between which the age and gender distribution was comparable (p > 0.05). With a median of 1.5 [IQR: 0-3], HD patients showed higher OHIP-G5 than the participants in KTx group (p < 0.01). Similarly, a significant difference was found between KTx (0, [0-0.5]) and HC (0, [0-3]; p < 0.01). HD patients showed a lower sum score of OHRSE, tooth-brushing, interdental-cleaning and dental-visit self-efficacy than the HC (p < 0.01). Similarly, HD patients had a lower sum score of OHRSE, tooth-brushing and dental-visit self-efficacy than the KTx group (p < 0.01). Moreover, the KTx group had a lower interdental-cleaning self-efficacy (p < 0.01) and sum score (p = 0.02) than the HC. The sum score of the general self-efficacy was comparable between the three groups (p = 0.19). The F-SozU-K14 revealed higher values in KTx (65.40 ± 5.33) compared with HD (60.95 ± 9.28) and HC group (61.71 ± 9.24; p = 0.03). Only in the KTx group, a significant association between F-SozU-K14 and OHIP-G5 was revealed (p = 0.05). CONCLUSIONS: Patients under HD show a reduced OHRSE compared to KTx and HC and a slightly reduced OHRQoL compared to KTx patients. While general self-efficacy was comparable between groups, social support of HD patients was lower than of KTx patients. The OHRSE and OHRQoL might receive increased attention in dental care of HD patients.