Discussion
gingiva, palate, pain, OLP
MINOR, CAVITY
Nowadays, the importance of utilizing patient-based outcomes alongside clinical outcomes has been recognized. The current study’s findings could support patient-centered care in evidence-based dentistry in relation to OLP treatment with topical corticosteroid. Most of the patients participating in this study benefited from using topical corticosteroids, as demonstrated by the improvement in the clinical and patient-based outcomes. We found that the highest and total Thongprasom sign scores for OLP were significantly decreased after 1-month treatment with topical corticosteroids compared with baseline. Several reviews revealed that topical corticosteroids are clinically effective and are considered the treatment of choice for OLP [OLP affects patient’s quality of life, however, effective treatment can improve their ability to perform everyday activities [The PGIC, the patients’ perception on their changing OHRQoL, results revealed that most patients reported improvement in various scales. However, the difference in the reduced clinical, pain and OIDP scores between those reporting up to moderately improved and greatly improved were not significant. Feine et al. [When considering the relationships between the changes in the clinical and patient-based outcomes after 1-month treatment with topical corticosteroids, we found significant relationships for the differences in patient-based outcomes (pain score and total OIDP percentage score) and the differences in clinical outcomes (highest Thongprasom sign score and total Thongprasom sign scores). These findings were as expected and confirmed the abovementioned discussion on the close relationship between outcomes assessed by different instruments belonging to the same concepts, either clinical or patient-based. Regarding the relationships between the difference in clinical outcomes and the difference in patient-based outcomes, the total Thongprasom sign score better correlated with patient-based outcomes, compared with the highest Thongprasom sign score. A possible explanation might relate to the different impacts from different OLP locations. A study reported that OLP occurring at different locations caused different degrees of symptoms, minor symptoms could be expected for lesions occurring at the buccal/labial mucosa, gingiva and palate, while the symptoms could be greater for tongue lesions [Our study’s weak point was the various types and forms of topical corticosteroids with different potencies used in the clinic. Most of our patients received 0.1% fluocinolone acetonide in orabase and 0.05% dexamethasone mouthwash for treating OLP. Thongprasom et al. [Another weak point was the different characteristics of the patients in this study, such as age, sex, duration of OLP, systemic conditions, medication, experience in OLP treatment and types of topical corticosteroid. Moreover, different numbers and locations of OLP in the oral cavity may have impacted the patient-based results and relationship between the clinical outcomes and patient-based outcomes as discussed above. The current study’s objectives did not include the analyses of the association between these factors and patients’ OHRQoL. Therefore, further studies using a larger sample size are recommended to explore the impacts of such factors, for example, type of topical corticosteroid, on clinical and patient-based outcomes after treatment. Such findings may be helpful for medical communication or further insurance planning. Lastly, the current study used the OIDP index, while many other studies have utilized other OHRQoL indices such as the OHIP. Thus, findings from different indices cannot be compared, which consequently, limit the building up knowledge in this field. Future research using the same index as studies in other countries is recommended in order to compare and combine the results through more impactful analyses, which would bring a more understanding on the impacts of OLP on dental patients globally and to support the pragmatic use of OHRQoL index in dental clinics.