• Casey D Wright, Daniel W McNeil, Cierra B Edwards, Richard J Crout, Katherine Neiswanger, John R Shaffer, and Mary L Marazita.
• Department of Psychology, West Virginia University, 53 Campus Drive, P.O. Box 6040, Morgantown, WV 26506, USA; Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA; Department of Dental Practice & Rural Health, Center for Oral Health Research in Appalachia (COHRA), School of Dentistry, West Virginia University, One Medical Center Drive, Morgantown, WV 26506, USA.
• Pain Res Manag. 2017 Jan 1; 2017: 5491923.

AbstractBackground. Oral health-related quality of life (OHRQoL) is impacted by periodontal disease and orofacial pain. There is a limited research examining the impact of avoidance of care or physiological arousal related to the fear of pain response on periodontal-related OHRQoL. Methods. Data are from the Center for Oral Health Research in Appalachia family-based study focusing on 1,339 adults. Measures included a modified Periodontal Screening and Recording Index across sextants of dentition, dental fear survey, Fear of Pain Questionnaire-9, and Oral Health Impact Profile-14. Structural equation modeling was used to estimate the effects of periodontal disease screening indicators on OHRQoL including the mediating role of dental fear while accounting for fear of pain. Results. A significant total effect was found for the mandibular anterior sextant, components of dental anxiety/fear, and indicators of OHRQoL (pain and discomfort, β = .165, p = .001; psychosocial impact, β = .199, p < .001). The maxillary anterior region was significantly associated with pain discomfort (β = .116, p = .017) and functionality (β = .130, p = .011). Conclusions. Findings provide a granular perspective of periodontal disease indicators and OHRQoL. Dental avoidance/anticipatory fear and physiological arousal mediate OHRQoL in individuals who have indicators of periodontal disease in sextants that may be visible and susceptible to higher pain and psychosocial impact.

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