Periodontal Condition and Immunological Aspects of Individuals Hospitalized in the Intensive Care Unit

Abstract

There are few studies on the clinical and immunological periodontal status of intensive care unit (ICU) in-patients. The aim of the present study was to evaluate the periodontal condition among ICU in-patients through clinical and immunological periodontal parameters. From the sample of 373 hospitalized ICU patients, 182 were submitted' to a thorough clinical periodontal and immunological evaluation. Data on bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were collected and gingival sulcular fluid samples were quantified through ELISA on IL-1, IL-6, and MMP-2 for immunological evaluation. Data was statistically analyzed by Chi-square, Fisher's exact, Mann-Whitney tests, and Sperman's correlation and multivariate logistic regression analysis. A high dental plaque index and a high prevalence of periodontitis (48.3%), mostly in moderate and localized chronic form, were observed. Individuals with periodontitis presented higher levels of IL-1 and MMP-2, while individuals with cardiovascular disease (CVD) and individuals with two or more systemic diseases (MSD) presented higher levels of IL-1; diabetes mellitus (DM) and MSD individuals presented higher levels of IL-6. A positive association was found between the severity of periodontitis and CVD (OR 2.2; CI = 1.11-4.42). This study reported a 48.3% of the prevalence of periodontitis in ICU patients and a positive association between the severity of periodontitis and CVD. Additionally, higher levels of IL-1 and MMP-2 were found in individuals with periodontitis, higher levels of IL-6 were found in individuals with DM, and higher levels of IL-1 were found in individuals with CVD.

Oral Hygiene Practice among Hospitalized Patients: An Assessment by Dental Hygiene Students

“…The Plaque Index was quite high in all hospital wards (from 52% to 90%), with the exception of gynecology and surgery (52% and 62% respectively). This discovery highlights the need for strong motivation, and is in agreement with some studies in the literature, which emphasized worsening oral conditions during hospitalization, with the increase of oral biofilm [ 22 , 23 , 24 , 25 ]. As for patients’ oral hygiene procedures, a large number used a manual toothbrush (from 66% to 100% of patients admitted, especially in oncology).…”

“…Although few data are available in the literature, oral health worsens during hospitalization for several reasons. Many patients, in fact, become dependent on hospital staff for care and oral hygiene, which is usually poorly prepared, and has no data available (especially for patients in the intensive care unit), thus favoring the deterioration of oral conditions [ 22 ]. Some studies have shown an increase in plaque and gingival inflammation after even short periods of hospitalization, as well as an increase in the Bleeding on Probing index [ 23 , 24 ].…”

Avaliação de um programa de telemonitoramento em odontologia para pessoas com deficiência

“…Desordens bucais podem cursar com dor, desconforto e prejudicar funções como mastigar, falar, deglutir e sorrir (Baiju et al, 2017), além de afetar a qualidade de vida (Guerra et al, 2014). Ademais, estudos apontaram a influência sobre a etiopatogenia de enfermidades sistêmicas (Albuquerque et al, 2018). Na PcD, a prevalência de cárie e doença periodontal depende do comprometimento físico/mental, da idade, da situação da HB (Queiroz et al, 2014), do uso contínuo de medicamentos, dieta cariogênica, respiração bucal, anormalidade de oclusão (Pini, et al, 2013) e baixo letramento em saúde bucal dos pais (Montes et al, 2017).…”

Condição oral de pacientes imunocomprometidos internados em Unidade de Terapia Intensiva

“…As doenças periodontais, principalmente se estiverem associadas as patologias sistêmicas, sinalizam um risco para o quadro sistêmico de grupos fragilizados 18,19 .…”