Time-dependent effect of isotretinoin use on oral health related quality of life in acne vulgaris patients: a longitudinal study

Abstract

Abstract Background This longitudinal designed study evaluated the impact of systemic isotretinoin use on oral health-related quality of life (OHRQoL) through its effects on clinical periodontal parameters, salivary flow rate, and patient-reported oral symptoms. Methodology Twenty-four periodontally healthy patients who prescribed systemic isotretinoin for acne vulgaris treatment were enrolled. Sociodemographic data, patient-reported oral symptoms and periodontal parameters were recorded, salivary flow rate (SFR) calculated and oral health-related quality of life assessed through OHIP14-TR scales at 4 different timepoints: before (T0), at the 6th week (T1), at the 5th month (T2), and after the completion (T3) of isotretinoin treatment. Friedman test was used to compare data between each follow up and Generalized Estimating Equations (GEE) were utilized to identify the associations between clinical parameters and OHRQoL scores. P-values of < 0.05 was considered statistically significant. Results Isotretinoin use led to a transient increase in self-reported salivary dryness (T1:66.7%) ( p < 0.05) and burning sensation (T1:16.7%) ( p < 0.05), and resolving post-treatment. No significant changes were observed in oral hygiene behaviors, clinical attachment levels, or plaque index ( p > 0.05). However, a significant increase in bleeding on probing (T2:8.58%) ( p < 0.05) and gingivitis incidence (T2:33.3%) ( p < 0.05) was observed. GEE indicated that while OHIP-14TR scores remained stable overall ( p > 0.05), both oral burning sensations ( p < 0.05) and bleeding on probing ( p < 0.05) were significant predictors of transient shifts in OHRQoL during the early phases of treatment. Conclusion Transient oral symptoms, including xerostomia and subclinical gingival inflammation, were observed during systemic isotretinoin therapy with minimal impact on absolute OHRQoL scores. However, our longitudinal model identified oral burning and gingival bleeding as significant predictors of transient shifts in patient-reported outcomes, occurring without permanent periodontal lesions.