Oral health status of adult heart transplant recipients in China

Abstract

Limited information on the oral health status of adult heart transplant recipients (HTRs) is known, and no available data exist in China. A prerequisite dental evaluation is usually recommended for patients’ postorgan transplantation because lifelong immunosuppression may predispose them to infection spread.The aim of this study was to investigate the oral health status of Chinese adult HTRs and determine the association between oral health status and history of heart transplantation (HT).We carried out a cross-sectional study to collect clinical, demographic, socioeconomic, and behavioral data from 81 adult patients who received heart transplantation during 2014 to 2015 in China. Clinical examinations for the presence of dental plaque, dental calculus, dental caries, and periodontal health conditions were performed in a standardized manner by one trained examiner. Sociodemographic, socioeconomic, and behavioral data were self-reported using questionnaires. The prevalence of the above conditions was compared with 63 age- and sex-matched controls. General liner regression analysis was used to assess associations between mean number of decayed, missing, and filled teeth (DMFT) and mean community periodontal index of treatment needs (CPITN) scores and history of heart transplant.Mean age of the HT group was 47.7 ± 12.2 years and men accounted for 69.1% of the sample. The overall median DMFT score in the HT group was 3 (1–5) and caries prevalence was 80.2%, which were similar to the control group (P > .05). The overall mean CPITN score of the HT group was 1.84, which was significantly higher than the control group (1.07, P = .001). Participants in the HT group had worse oral hygiene status and more teeth with probing depth ≥ 4 mm than controls (P = .043). Compared with participants who had no history of heart transplantation, HTRs presented worse periodontal health conditions (mean CPITN score, adjusted odds ratio (OR) = 1.39, 95% confidence interval (CI) = 1.12–1.71, P = .003) and similar dental caries status (DMFT score, adjusted OR = 0.58, 95% CI = 0.37–0.91, P = .058).Periodontal health status was positively associated with history of heart transplantation in Chinese adult HTRs.

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?

“…Accordingly, a high periodontal treatment need of patients with HI and after HTx, which is almost higher than for the German general population in the DMS V [20] can be concluded. This result is in line with a recent Chinese cross-sectional study, which presented worse periodontal conditions for HTx recipients, while dental care status was comparable to healthy controls [12]. Similarly, patients who received a solid organ transplantation (kidney, liver, lung) were found to present high periodontal treatment need, irrespective of time since transplantation [7,8,9,10,11].…”

“…Data for heart transplant recipients are still rare in the literature. A recent Chinese cross-sectional study presented worse periodontal conditions for heart transplant recipients [12]. It was also shown that periodontal inflammation would be associated with systemic inflammatory parameters in heart transplanted individuals [13].…”

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

“…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]. Furthermore, patients with other solid organ transplantation, including kidney, liver and lung suffer from a high periodontal treatment need, regardless of their time period since transplantation [13].…”

“…In contrast, patients with heart transplantation were found to suffer from high periodontal treatment need [12]. While further data for heart transplant recipients are lacking, findings of patients with other solid organ transplantations suggest the absent of sufficient rehabilitation before and maintenance after transplantation [13].…”

Evaluation of the Prevalence of Systemic Diseases in Patients Referring to the Oral and Maxillofacial Medicine Department of the Dental Branch of Islamic Azad University of Tehran During 2016-17

“…(3)(4)(5)(6) Cardiovascular diseases, respiratory diseases, diabetes, and adverse outcomes of pregnancy are associated with oral diseases including periodontitis. (2,7,8) Bacterial endocarditis is one of the most serious problems in dentistry. (9) The incidence of systemic diseases in studies conducted in India, Saudi Arabia, Tehran, and Mashhad has been reported to be 10.3% to 52.8%.…”