Psychological Factors and Quality of Life in Oral Mucosal Diseases: A Systematic Review

Abstract

Background: Oral mucosal diseases can affect patients beyond their physical symptoms, influencing psychological well-being, social interactions, and overall quality of life. Conditions such as oral lichen planus, recurrent aphthous stomatitis, and oral submucous fibrosis may be associated with anxiety, depression, and psychological stress.
Aim: This systematic review aimed to investigate the relationship between psychological factors and quality of life among patients with oral mucosal diseases.
Methods: A systematic literature search was conducted across PubMed, Scopus, Web of Science, and the Cochrane Library to identify relevant studies. Following the PRISMA guidelines, 1,248 records were identified, and 286 duplicates were removed. After screening 962 records by title and abstract, 78 full-text articles were assessed for eligibility. Of these, 25 studies met the inclusion criteria and were included in the final review. Relevant data concerning psychological factors and quality-of-life outcomes were extracted and synthesized narratively.
Results: The 25 included studies investigated psychological factors, including anxiety, depression, and stress, in relation to quality of life among patients with oral mucosal diseases. Overall, the findings suggested that psychological distress was associated with poorer quality of life, particularly among patients experiencing persistent pain, recurrent ulceration, and chronic oral mucosal inflammation. Anxiety and depressive symptoms were frequently associated with greater psychological burden and limitations in daily activities and social functioning. However, the strength of these associations varied according to the type of oral mucosal disease, symptom severity, and assessment instruments.
Conclusion: Oral mucosal diseases may significantly affect patients’ psychological well-being and quality of life through persistent symptoms, functional limitations, and social difficulties, highlighting the importance of recognizing anxiety, depression, and psychological stress as relevant aspects of patient care. Integrating psychological assessment with clinical evaluation and providing appropriate supportive interventions may contribute to more comprehensive, patient-centered management and improved quality of life.