Fig. 4.

OHRQoL of patients undergoing HD is complex. Different oral health as well as disease-related parameters affect different dimensions of OHRQoL. Furthermore, disease-related factors affect the oral health situation of the patients and, in consequence, OHRQoL. While pain and function is primarily affected by oral health, the psychosocial impact is affected by oral conditions and disease related parameters. Diabetes as a disease-related parameter can cause diabetic neuropathy in the oral cavity and might influence the pattern pain. This figure is just a simplified construct; the clinical interrelation is far more complex