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This cross-sectional study included 99 patients with SSc. Oral handicap was assessed using the Mouth Handicap in Systemic Sclerosis Scale (MHISS). Social appearance anxiety, anxiety\/depression symptoms, resilience, and quality of life were evaluated using the Social Appearance Anxiety Scale, Hospital Anxiety and Depression Scale, Brief Resilience Scale, and World Health Organization Quality of Life\u2013BREF (WHOQOL-BREF), respectively. Statistical and hierarchical multiple regression analyses were also performed. Oral handicap was associated with female sex (rho\u2009=\u20090.220, p\u2009=\u20090.029) and diffuse cutaneous SSc subtype (rho\u2009=\u2009\u2009\u2212\u20090.482, p\u2009&lt;\u20090.001). Oral handicap showed strong positive correlations with the facial and total modified Rodnan Skin Score (rho\u2009=\u20090.851 and rho\u2009=\u20090.737; both p\u2009&lt;\u20090.001). Positive associations were also observed for gastrointestinal (GI) involvement, calcinosis, telangiectasia, Scl-70 positivity, and digital ulcers (p\u2009&lt;\u20090.002 for all). MHISS scores were positively correlated with anxiety, depression, and social appearance anxiety, and negatively correlated with all WHOQOL-BREF domains (p\u2009&lt;\u20090.001 for all). In the regression analyses, mRSS (\u03b2\u2009=\u20090.484, p\u2009&lt;\u20090.001), GI involvement (\u03b2\u2009=\u20090.210, p\u2009=\u20090.006), and anxiety scores (\u03b2\u2009=\u20090.183, p\u2009=\u20090.036) remained independently associated with oral impairment. The clinical model explained an additional 54% of variance, with a further 5% contributed by psychosocial variables. Oral impairment in SSc reflects both clinical disease burden and psychosocial distress, underscoring its multifactorial nature.<\/jats:p>","DOI":"10.1007\/s00296-026-06198-x","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T06:57:54Z","timestamp":1782111474000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical and psychosocial determinants of oral handicap in systemic sclerosis: a cross-sectional study"],"prefix":"10.1007","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6152-8314","authenticated-orcid":false,"given":"Merve","family":"Erdo\u011fan Soysal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5192-9045","authenticated-orcid":false,"given":"Ipek","family":"Turk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7894-4269","authenticated-orcid":false,"given":"Ay\u015feg\u00fcl","family":"\u00d6zdo\u011fan Bircan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8606-5601","authenticated-orcid":false,"given":"Metehan","family":"Soysal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"issue":"1","key":"6198_CR1","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1136\/ard-2024-226430","volume":"84","author":"FD Galdo","year":"2025","unstructured":"Galdo FD, Lescoat A, Conaghan PG, Bertoldo E, \u010coli\u0107 J, Santiago T et al (2025) EULAR recommendations for the treatment of systemic sclerosis: 2023 update. 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Rheumatol Int 46:36","journal-title":"Rheumatol Int"}],"container-title":["Rheumatology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00296-026-06198-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00296-026-06198-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00296-026-06198-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T07:17:17Z","timestamp":1784272637000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00296-026-06198-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":46,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["6198"],"URL":"https:\/\/doi.org\/10.1007\/s00296-026-06198-x","relation":{},"ISSN":["1437-160X"],"issn-type":[{"value":"1437-160X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,22]]},"assertion":[{"value":"3 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors have declared no conflicts of interest regarding the publication of this manuscript. No external commercial sponsors, agencies, or representatives were involved in the preparation of this article. This study was adapted from the medical specialty thesis entitled \u201cEffects of Mouth Opening on Quality of Life, Anxiety Level, and Body Image in Patients with Systemic Sclerosis\u201d (Dr. Merve Erdo\u011fan Soysal, Advisor: Assoc. Prof. Ipek Turk, Department of Internal Medicine, Faculty of Medicine, \u00c7ukurova University, Adana, 2024).","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors confirm that this article, including the text and graphics, has not been copied in whole or in part, published elsewhere, or generated by AI. This work has not previously been presented as a conference abstract or published in any abstract book.","order":2,"name":"Ethics","label":"Disclaimer","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Open access funding provided by the Scientific and Technological Research Council of T\u00fcrkiye (T\u00dcB\u0130TAK).","order":3,"name":"Ethics","label":"Open access funding","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"159"}}