Impact of Prosthetic Rehabilitation on Oral Health-Related Quality of Life in Patients With Oral Cancer at a Tertiary Care Center in Kerala

Abstract

Negative physical and psychological impacts may result from oral cancer and its treatment, causing social isolation and a decreased quality of life. Restoring the patient's functional and psychological well-being following reconstructive surgery requires prosthetic rehabilitation. This study aimed to determine the effect of prosthetic rehabilitation on Oral Health-Related Quality of Life (OHRQoL) in patients with oral cancer, comparing pre- and postrehabilitation statuses. Forty-four patients who met the inclusion criteria of having completed treatment for various oral cancers and requiring prosthetic rehabilitation, with an age range of 20-75 years, were selected for the study. Using Liverpool Oral Rehabilitation Questionnaire version 3 (LORQv3) and Oral Health Impact Profile (OHIP)-14, study participants completed a self-report survey questionnaire on their experiences with oral problems before rehabilitation and at one month and six months postrehabilitation. Normality was assessed, and comparisons of outcome variables were performed using repeated measures analysis of variance. A correlation analysis was performed between related continuous variables using the Pearson correlation test. A noticeable improvement was observed in almost all domains of LORQv3 and OHIP-14, across both follow-ups. Regarding oral function, the LORQv3 showed improvement in chewing (3.39 ± 0.78 → 2.24 ± 0.60 → 1.54 ± 0.44, η² = 0.874) and swallowing (3.48 ± 0.76 → 1.96 ± 0.60 → 1.32 ± 0.41, η² = 0.879) from prerehabilitation to one and six months postrehabilitation, respectively. Similarly, OHIP-14 domains of functional limitation (3.09 ± 0.75 → 1.05 ± 0.81 → 0.50 ± 0.72, η² = 0.854) and physical disability (3.00 ± 0.74 → 1.06 ± 0.75 → 0.46 ± 0.58, η² = 0.841) reflected comparable improvements. In terms of comfort and physical well-being, LORQv3 salivation (2.65 ± 0.84 → 1.70 ± 0.44 → 1.29 ± 0.33, η² = 0.703) and mouth opening (2.77 ± 0.96 → 1.77 ± 0.74 → 1.36 ± 0.48, η² = 0.708) scores decreased steadily, aligning with OHIP-14 physical pain (3.17 ± 0.65 → 1.13 ± 0.87 → 0.51 ± 0.75, η² = 0.847), indicating reduced oral discomfort. Improvements in speech, appearance, and psychosocial domains were also evident, with LORQv3 speech (3.36 ± 0.74 → 2.06 ± 0.78 → 1.52 ± 0.62, η² = 0.782), orofacial appearance (3.18 ± 0.88 → 2.09 ± 0.72 → 1.67 ± 0.74, η² = 0.728), and social interaction (3.31 ± 0.90 → 2.13 ± 0.66 → 1.65 ± 0.74, η² = 0.758) showing consistent enhancement. Correspondingly, OHIP-14 domains such as psychological discomfort (2.92 ± 0.81 → 1.21 ± 1.08 → 0.61 ± 0.93, η² = 0.775), social disability (3.27 ± 0.81 → 2.15 ± 1.30 → 1.82 ± 1.44, η² = 0.482), and handicap (3.97 ± 0.67 → 2.69 ± 1.13 → 2.01 ± 1.15, η² = 0.788) demonstrated progressive improvement. Overall, both LORQv3 and OHIP-14 revealed parallel trends with mean score reductions of approximately 1.5-2.5 points across overlapping domains, confirming significant enhancement in oral function, comfort, and psychosocial quality of life following rehabilitation. Gender, economic status, geography, and treatment type significantly influenced outcomes of LORQv3 and OHIP-14. Strong correlations between domains of OHIP-14 and LORQv3 were observed. These results highlight the importance of timely, interdisciplinary prosthetic rehabilitation, which not only facilitates functional restoration but also greatly improves OHRQoL.