Study after study has shown excellent clinical success or survival rates of teeth after endodontic treatment. But evaluating outcomes based only on clinical parameters overlooks current trends that emphasize patient-centered outcomes, especially quality of life (QoL). Oral health-related quality of life (OHRQoL) indices allow us to expand outcome measures beyond the mere absence of disease to include physical, psychosocial and social well-being. Unfortunately, only 1 systematic review that addresses OHRQoL after endodontic treatment has been published.
Leong and Yap from Ng Teng Fong General Hospital, Singapore, attempted to remedy this lack of knowledge by conducting a systematic review of articles published through July 2018 that reported studies of QoL in patients who received endodontic treatment. Included in the review were clinical studies that measured QoL in patients.
≥18 years of age
who received any endodontic treatment
with a functional coronal restoration of ≥6 months
The authors found 6 (3 cross-sectional, 1 case-control and 2 cohort) studies that met their criteria.
All the published papers involved nonsurgical root canal therapy; no studies evaluating QoL after endodontic surgery required ≥6 months of occlusal function. Four of the 6 studies concluded that nonsurgical root canal treatment improved patients’ OHRQoL. The remaining 2 studies, which focused on patients with persistent pain after endodontic treatment, found that persistent pain had a negative impact on those patients’ QoL but had minimal impact on daily activities. Five studies that looked at patient satisfaction stratified by who had performed the root canal treatment (endodontist, general dentist, postgraduate student) arrived at inconsistent results, although the authors suggested that the results could have been influenced by the fact that endodontists tend to treat more complex cases.
Although the evidence remains scanty, the existing studies show that nonsurgical endodontic treatment improves patients’ QoL. Further research in this area could help practitioners understand how patients’ perceptions and preferences should be considered when planning treatment.
Leong DJX, Yap AU-J. Quality of life of patients with endodontically treated teeth: a systematic review. Aust Endod J 2019;doi:10.1111/aej.12372.