Insufficient Oral Behaviour and the High Need for Periodontal Treatment in Patients with Heart Insufficiency and after Heart Transplantation: A Need for Special Care Programs?

Binner, Christian; Wagner, Justus; Schmalz, Gerhard; Eisner, M; Rast, Josephine; Kottmann, Tanja; Haak, Rainer; Oberbach, Andreas; Borger, Michael A.; Garbade, Jens; Ziebolz, Dirk

doi:10.3390/jcm8101668

Cited by 15 publications

(18 citation statements)

References 28 publications

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“…The high prevalence of periodontal treatment need in both groups was the main finding within oral health findings of the current study. A high periodontal treatment need in the HC is in line with similar findings of the Fifth German Oral Health Study, a representative study of German general population . This seems to be the explanation why there is no difference between LVAD and HC group.…”

Section: Discussionsupporting

confidence: 88%

“…However, there is still no study available that examined the recent dental care situation of patients with LVAD. A previous study by this working group was able to demonstrate a high periodontal treatment need in patients with heart insufficiency and after heart transplantation 11 . Moreover, it is still unclear whether oral diseases could be associated to driveline infections as a complication of high clinical relevance.…”

Section: Introductionmentioning

confidence: 97%

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Oral health and dental behaviour of patients with left ventricular assist device: a cross‐sectional study

et al. 2020

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Aims The aim of this cross-sectional study was the assessment of dental behaviour, oral health, as well as oral health-related quality of life of patients with left ventricular assist device (LVAD). Methods and results Patients (128) with LVAD were recruited A healthy control group (HC, n = 113) was included. Dental behaviour was assessed with a standardized questionnaire, and to evaluate oral health-related quality of life, the German short form of oral health impact profile was applied. The presence of decayed, missing, and filled teeth; dental treatment need; periodontitis severity; and periodontal treatment need were assessed. These findings were correlated to disease-related and device-related factors. The minority of patients used aids for interdental hygiene (16.4%). For the LVAD patients, a German short form of oral health impact profile sum score of 4.96 ± 8.67 [0.5; 0-6] was assessed. The LVAD group suffered from more missing teeth (11.91 ± 9.13 vs. 3.70 ± 3.77; P < 0.01) than HC. More severe periodontitis was found in LVAD group (LVAD = 41.4% and HC = 27.4%; P < 0.01). Periodontal treatment need was high in both groups, without a significant difference (LVAD = 84.4% vs. HC = 86.7%; P = 0.71). LVAD therapy as bridge to transplantation was correlated with periodontal treatment need (odds ratio = 11.48 [1.27; 103.86]; P = 0.03). Further correlations between treatment need and disease specific factors were not detected. Conclusions Patients with LVAD suffer from a high periodontal treatment need and a lack in oral behaviour. Interdisciplinary special care concepts appear recommendable to improve oral health in LVAD patients.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 97%

Oral health and dental behaviour of patients with left ventricular assist device: a cross‐sectional study

et al. 2020

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“…This could be additionally negatively influenced by the increased risk for complications of these patients during dental therapy [11,19,29,30], which might result in uncertainty of the dentist and thus in waiver of invasive (periodontal) therapy. This gap in periodontal treatment substantiates the demand of special care programs by specialized dentists with an interdisciplinary approach as demanded in literature [8,13,18].…”

Section: Discussionmentioning

confidence: 77%

“…The higher number of missing teeth in the heart diseased cohort might indicate a surgical dental rehabilitation prior to HTx, LVAD implantation or listing for potential HTx in HF group. A previous cross-sectional study of patients with HF and after HTx also showed a high periodontal treatment need of these patients [18]. Moreover, another recent cross-sectional study of Chinese HTx recipients also found high periodontal treatment need for these patients [12].…”

Section: Discussionmentioning

confidence: 85%

“…This gap in dental healthcare of these patients is supported by different examinations that presented high treatment need in patients before and after organ transplantation [14][15][16][17]. In this respect, a previous study by this working group showed a high periodontal treatment need of patients with heart failure and after heart transplantation [18]. Up until now, possible solutions to improve this insufficient dental care situation remain questionable.…”

Section: Introductionmentioning

confidence: 99%

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Lack in Periodontal Care of Patients Suffering from Severe Heart Diseases—Results after 12 Months Follow-Up

Ziebolz

Friedrich

Binner

et al. 2020

JCM

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Background: To assess whether the standardized recommendation of patients with heart failure (HF), left-ventricular assist device (LVAD) and heart transplantation (HTx) to visit their dentist leads to improved oral conditions after 12 months. Methods: Patients from the Department of Cardiothoracic Surgery, Leipzig Heart Centre, Germany were examined at baseline and after 12 months. A dental (decayed-, missing-, and filled-teeth index (DMF-T)) and periodontal examination (periodontal probing depth, clinical attachment loss) was performed. At baseline, patients received a standardized recommendation to visit their dentist. At follow-up, a standardized questionnaire regarding the dental consultation was applied. Results: Eighty-eight participants (HTx: 31, LVAD: 43, HF: 14) were included. The majority of patients (79.5%) followed the recommendation to visit their dentist. Within the total cohort, periodontal treatment need was significantly reduced from 91% (baseline) to 75% (follow-up; p < 0.01). Only 10% of total cohort stated that they received periodontal treatment. The outcome in periodontal and dental treatment need at follow-up appointment revealed no statistically significant associations to the questionnaire regarding dentist consultation (p > 0.05). Conclusions: The simple recommendation to visit the dentist appears not enough to obtain sufficient dental and periodontal conditions in patients with severe heart diseases. Thereby, a lack in periodontal treatment of patients with HF, HTx and LVAD was identified, making interdisciplinary dental special care programs recommendable.

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Comparison of periodontal parameters between patients with ischemic and dilative cardiomyopathy

Ziebolz

Binner

Reuschel

et al. 2021

BMC Cardiovasc Disord

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Background This cross-sectional study aimed in the comparison of periodontal parameters, number of remaining teeth and oral behaviour between patients with ischemic- (ICM) and non-ischemic dilative cardiomyopathy (DCM). Methods Patients with HF from the Department for Cardiac Surgery at the Heart Center Leipzig were included. The two groups (ICM and DCM) were composed by matching according to age, gender and smoking habits. All participants received a comprehensive periodontal examination, including a periodontal probing on six measurement points of each tooth. Results A total of 226 patients (n = 113 each group) was included. Patients in DCM group used interdental cleaning significantly more often than ICM (23.9% vs. 12.5%, p = 0.04). The majority of patients in both groups (ICM: 83.6%, DCM: 84.6%, p = 0.23) were diagnosed with stage III–IV periodontitis. Periodontal parameters were comparable between groups (p > 0.05). Variance analysis revealed no influence of the group (ICM vs. DCM) on the number of remaining teeth (p = 0.16), periodontitis stage (p = 0.27) or the periodontal inflamed surface area (p = 0.62). Conclusions Patients with severe HF show high periodontal burden, without any differences between ICM and DCM group. Therefore, increased attention should be payed to periodontal health of patients with severe heart disease, irrespective of their underlying disease.

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Insufficient Oral Behaviour and the High Need for Periodontal Treatment in Patients with Heart Insufficiency and after Heart Transplantation: A Need for Special Care Programs?

Cited by 15 publications

References 28 publications

Oral health and dental behaviour of patients with left ventricular assist device: a cross‐sectional study

Oral health and dental behaviour of patients with left ventricular assist device: a cross‐sectional study

Lack in Periodontal Care of Patients Suffering from Severe Heart Diseases—Results after 12 Months Follow-Up

Comparison of periodontal parameters between patients with ischemic and dilative cardiomyopathy

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