{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:48:21Z","timestamp":1787017701067,"version":"build-2736575974"},"reference-count":65,"publisher":"Wiley","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000072","name":"National Institute of Dental and Craniofacial Research","doi-asserted-by":"publisher","award":["R01 DE014899"],"award-info":[{"award-number":["R01 DE014899"]}],"id":[{"id":"10.13039\/100000072","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pain Research and Management"],"published-print":{"date-parts":[[2017]]},"abstract":"<jats:p>\n                    <jats:italic>Background<\/jats:italic>\n                    . Oral health-related quality of life (OHRQoL) is impacted by periodontal disease and orofacial pain. There is a limited research examining the impact of avoidance of care or physiological arousal related to the fear of pain response on periodontal-related OHRQoL.\n                    <jats:italic>Methods<\/jats:italic>\n                    . Data are from the Center for Oral Health Research in Appalachia family-based study focusing on 1,339 adults. Measures included a modified Periodontal Screening and Recording Index across sextants of dentition, dental fear survey, Fear of Pain Questionnaire-9, and Oral Health Impact Profile-14. Structural equation modeling was used to estimate the effects of periodontal disease screening indicators on OHRQoL including the mediating role of dental fear while accounting for fear of pain.\n                    <jats:italic>Results<\/jats:italic>\n                    . A significant total effect was found for the mandibular anterior sextant, components of dental anxiety\/fear, and indicators of OHRQoL (pain and discomfort,\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                      <mml:mi>\u03b2<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mo>.<\/mml:mo>\n                      <mml:mn fontstyle=\"italic\">165<\/mml:mn>\n                    <\/mml:math>\n                    ,\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                      <mml:mi>p<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mo>.<\/mml:mo>\n                      <mml:mn fontstyle=\"italic\">001<\/mml:mn>\n                    <\/mml:math>\n                    ; psychosocial impact,\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                      <mml:mi>\u03b2<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mo>.<\/mml:mo>\n                      <mml:mn fontstyle=\"italic\">199<\/mml:mn>\n                    <\/mml:math>\n                    ,\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                      <mml:mi>p<\/mml:mi>\n                      <mml:mo>&lt;<\/mml:mo>\n                      <mml:mo>.<\/mml:mo>\n                      <mml:mn fontstyle=\"italic\">001<\/mml:mn>\n                    <\/mml:math>\n                    ). The maxillary anterior region was significantly associated with pain discomfort (\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                      <mml:mi>\u03b2<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mo>.<\/mml:mo>\n                      <mml:mn fontstyle=\"italic\">116<\/mml:mn>\n                    <\/mml:math>\n                    ,\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\">\n                      <mml:mi>p<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mo>.<\/mml:mo>\n                      <mml:mn fontstyle=\"italic\">017<\/mml:mn>\n                    <\/mml:math>\n                    ) and functionality (\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\">\n                      <mml:mi>\u03b2<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mo>.<\/mml:mo>\n                      <mml:mn fontstyle=\"italic\">130<\/mml:mn>\n                    <\/mml:math>\n                    ,\n                    <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\">\n                      <mml:mi>p<\/mml:mi>\n                      <mml:mo>=<\/mml:mo>\n                      <mml:mo>.<\/mml:mo>\n                      <mml:mn fontstyle=\"italic\">011<\/mml:mn>\n                    <\/mml:math>\n                    ).\n                    <jats:italic>Conclusions<\/jats:italic>\n                    . Findings provide a granular perspective of periodontal disease indicators and OHRQoL. Dental avoidance\/anticipatory fear and physiological arousal mediate OHRQoL in individuals who have indicators of periodontal disease in sextants that may be visible and susceptible to higher pain and psychosocial impact.\n                  <\/jats:p>","DOI":"10.1155\/2017\/5491923","type":"journal-article","created":{"date-parts":[[2017,3,9]],"date-time":"2017-03-09T16:04:16Z","timestamp":1489075456000},"page":"1-9","source":"Crossref","is-referenced-by-count":23,"title":["Periodontal Status and Quality of Life: Impact of Fear of Pain and Dental Fear"],"prefix":"10.1155","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1189-5877","authenticated-orcid":true,"given":"Casey D.","family":"Wright","sequence":"first","affiliation":[{"name":"Department of Psychology, West Virginia University, 53 Campus Drive, P.O. Box 6040, Morgantown, WV 26506, USA"},{"name":"Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA"},{"name":"Department of Dental Practice & Rural Health, Center for Oral Health Research in Appalachia (COHRA), School of Dentistry, West Virginia University, One Medical Center Drive, Morgantown, WV 26506, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0766-8455","authenticated-orcid":true,"given":"Daniel W.","family":"McNeil","sequence":"additional","affiliation":[{"name":"Department of Psychology, West Virginia University, 53 Campus Drive, P.O. Box 6040, Morgantown, WV 26506, USA"},{"name":"Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA"},{"name":"Department of Dental Practice & Rural Health, Center for Oral Health Research in Appalachia (COHRA), School of Dentistry, West Virginia University, One Medical Center Drive, Morgantown, WV 26506, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5526-4543","authenticated-orcid":true,"given":"Cierra B.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Psychology, West Virginia University, 53 Campus Drive, P.O. Box 6040, Morgantown, WV 26506, USA"},{"name":"Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA"},{"name":"Department of Dental Practice & Rural Health, Center for Oral Health Research in Appalachia (COHRA), School of Dentistry, West Virginia University, One Medical Center Drive, Morgantown, WV 26506, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Crout","sequence":"additional","affiliation":[{"name":"Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA"},{"name":"Department of Periodontics, Center for Oral Health Research in Appalachia (COHRA), School of Dentistry, West Virginia University, One Medical Center Drive, Morgantown, WV 26506, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1250-6813","authenticated-orcid":true,"given":"Katherine","family":"Neiswanger","sequence":"additional","affiliation":[{"name":"Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA"},{"name":"Department of Oral Biology, Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Bridgeside Point Suite 500, 100 Technology Drive, Pittsburgh, PA 15219, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1897-1131","authenticated-orcid":true,"given":"John R.","family":"Shaffer","sequence":"additional","affiliation":[{"name":"Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA"},{"name":"Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, 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