Poor Oral Health-Related Quality of Life in Pre- and Post-Liver Transplantation Patients

Larissa S. Santos-Lins1
, Inácio L.S. Aguiar1
, Liana Codes2, 3
, Maria A. Evangelista3
, Alessandra de Oliveira Castro3
, Paulo L. Bittencourt3
, Andrea Cavalcanti3
, Raymundo Paraná1, 2
, Liliane Lins-Kusterer1, 2, *

1 Postgraduate Program in Medicine and Health, FMB-UFBA, School of Medicine, Federal University of Bahia (FMB-UFBA), Bahia, Brazil
2 University Hospital Complex, Professor Edgard Santos, Federal University of Bahia (C-HUPES-UFBA), Bahia, Brazil
3 Unit of Gastroenterology and Hepatology, Portuguese Hospital, Salvador, Bahia, Brazil

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© 2021 Santos-Lins et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Postgraduate Program in Medicine and Health, FMB-UFBA, School of Medicine, Federal University of Bahia (FMB-UFBA), Bahia, Brazil; Tel: +55.71.992700660;



Oral health is associated with Chronic Liver Disease (CLD) and may play a relevant role in oral (OHRQoL) and general health-related quality of life (HRQoL) among people with chronic liver disease (CLD).


To explore the correlations between OHRQoL and HRQoL in pre- and post-liver transplantation (LT) patients.


A cross-sectional study with 189 patients: 63 per group (pre-LT, post-LT, and without liver disease). The Oral Health Impact Profile-14 (OHIP-14), the 36-Item Short-Form Health Survey, and the Work Ability Index (WAI) were used to measure oral health-related quality of life, health-related quality of life, and work ability, respectively. Oral health was evaluated according to the World Health Organization criteria. The relationship between the OHIP-14 and independent variables was analysed by multiple linear regression.


Pre-LT group presented the highest OHIP-14 total mean score, followed by the post-LT group, compared to the group without liver disease (p=0.001). All HRQoL and WAI mean scores were lower in the pre-LT group than in the other groups (p≤0.013). In the pre-LT group, the OHIP-14 total mean score was negatively correlated with the Mental Health, Physical Functioning, and General Health mean scores (p=0.01) and negatively and significantly (p<0.05) associated with decayed teeth and with poor workability. In the post-TL group, OHRQOL of life was associated with decayed and missing teeth, lower educational level, and poor workability.


Patients in the pre- and post-LT groups presented poorer OHRQoL compared to patients without liver disease. OHRQoL was strongly correlated with HRQoL in the pre-LT group.

Keywords: Oral Health, Health-Related Quality of Life, Liver Transplantation, Periodontal Diseases, Dental Caries, Oral Medicine.