Psychological and Social Trajectories During Dental Treatment: A Prospective Cohort Study on Oral Health-Related Quality of Life

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Abstract
Background: Patients undergoing dental treatment often experience psychological distress and social discomfort, yet longitudinal data on these changes are limited. Existing studies rely on cross-sectional designs or lengthy tools, reducing feasibility in routine practice. This study explored psychological and social trajectories during dental care, highlighting challenges and implications for patient wellbeing and care delivery. Methods: A prospective cohort study with repeated measures across three dental visits (V1–V3) was conducted. Participants completed a 21-item binary (yes/no) questionnaire assessing psychological (Q1–Q6) and social dimensions (Q7–Q14 at all visits; extended social domain Q7–Q21 at V2–V3). Composite scores were calculated, and longitudinal changes were analyzed using generalized estimating equations or mixed-effects models. Item-level trajectories were examined with multiple comparison adjustments. Results: Of 120 enrolled patients, 100 completed all visits. Psychological well-being consistently improved, while social outcomes showed more complex, domain-specific patterns. Item-level analyses revealed gains in appearance and satisfaction, whereas stigma, fear, and social integration remained relatively stable, underscoring the need to monitor multiple psychosocial dimensions. Conclusions: Psychosocial monitoring during dental care is feasible and potentially beneficial. The 21-item questionnaire was practical and well-accepted, with composite scores serving as simple indicators for tracking patient wellbeing and supporting a holistic, patient-centered approach. Further validation in larger and more diverse populations is needed.
Funding Information
  • “Dunarea de Jos” University of Galati, Romania

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