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

Abstract

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.

No Association between Clinical Periodontal Conditions and Microbiological Findings on Driveline of Patients with Left-Ventricular Assist Devices (LVAD)

“…This is comparable to other studies with severely heart diseased individuals [9,[27][28][29][30]. This highlights a healthcare gap that has already been addressed previously [10]. However, this high prevalence might blur the potential of periodontal disease as a risk indicator because only a minority of patients were periodontally healthy or mildly diseased, respectively.…”

“…Patients suffering from severe HF who are treated by LVAD have been found to show insufficient oral health conditions, especially a high prevalence of periodontal diseases and an enormous need for periodontal treatment [9,10]. Overall, the dental management of these severely diseased patients is difficult [11,12].…”

Oral health-related quality of life of patients after solid organ transplantation is not affected by oral conditions: results of a multicentre cross-sectional study

“…This is in line with the current study´s findings. However, the high periodontal burden of SOT recipients, as shown in the literature ( 4 , 7 , 22 ), appears not to be significantly higher than in healthy controls. In this respect, the high prevalence of periodontal treatment need in German general population, reflected in the fifth German oral health study should be considered ( 23 ).…”

“…Accordingly, a lack in dental care of SOT recipients appears evident. An observational study with 12 months follow-up after dentist allocation of patients after heart transplantation revealed more than 70% of patients to show periodontal treatment need, although they had visited a dentist, underlining the lack of appropriate dental care of these patients ( 7 ).…”

Special Issue “Oral Health and Systemic Diseases”

“…Altogether, the authors conclude special dental care to be necessary for children and adolescents suffering from juvenile idiopathic arthritis. A prospective cohort study by Ziebolz et al [ 12 ] was performed to assess whether a single recommendation of 88 patients with severe heart disease to visit their dentist leads to improved oral findings after 12 months follow-up. While the majority of participants followed the recommendation, only a slight reduction in periodontal treatment need was observed; thereby only 10% of individuals stated that they had received a periodontal therapy, albeit a periodontal treatment need was obvious in 91% of patients at baseline.…”