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Church LA, Robins L, Xu F, Qin L, Tran A, Wallace JP, King S. Oral health education strategies for patients living with cardiovascular disease within hospital settings: a scoping review. Front Public Health 2024; 12:1389853. [PMID: 38962771 PMCID: PMC11220159 DOI: 10.3389/fpubh.2024.1389853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 06/07/2024] [Indexed: 07/05/2024] Open
Abstract
Objective To identify and describe the impact of current oral health education programmes provided to patients in cardiology hospital wards and outpatient clinics. Methods This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews statement. Searches were conducted using electronic databases: Cochrane, Medline, and Scopus, as well as grey literature searching. Results Three eligible studies were identified. All included studies reported generalised poor oral health in their participants at baseline, with significant improvement at follow-up. They all reported significant reductions in plaque deposits and gingival bleeding. One study reported significantly less bacteria on participant tongues, as well as fewer days with post-operative atrial fibrillation in the intervention group. Furthermore, in this study, one patient in the intervention group developed pneumonia, whilst four patients in the control group did. Conclusion Oral health education for patients with cardiovascular disease is limited and many have poor oral health. Educational programmes to improve oral health behaviours in patients with cardiovascular disease can improve both oral and general health outcomes. Implications for public health Oral disease is a modifiable risk factor for cardiovascular disease. Integrating oral health education into cardiology hospital settings is a simple strategy to improve access to oral health information and improve both oral and cardiovascular outcomes.
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Affiliation(s)
- L. A. Church
- The University of Sydney Dental School, The University of Sydney, Sydney, NSW, Australia
- Westmead Applied Research Centre, The University of Sydney, Westmead, NSW, Australia
| | - L. Robins
- The University of Sydney Dental School, The University of Sydney, Sydney, NSW, Australia
| | - F. Xu
- The University of Sydney Dental School, The University of Sydney, Sydney, NSW, Australia
| | - L. Qin
- The University of Sydney Dental School, The University of Sydney, Sydney, NSW, Australia
| | - A. Tran
- The University of Sydney Dental School, The University of Sydney, Sydney, NSW, Australia
| | - J. P. Wallace
- School of Health Sciences, Oral Health, The University of Newcastle, Ourimbah, NSW, Australia
| | - S. King
- The University of Sydney Dental School, The University of Sydney, Sydney, NSW, Australia
- Westmead Applied Research Centre, The University of Sydney, Westmead, NSW, Australia
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Chu C, Liu S, Nie L, Hu H, Liu Y, Yang J. The interactions and biological pathways among metabolomics products of patients with coronary heart disease. Biomed Pharmacother 2024; 173:116305. [PMID: 38422653 DOI: 10.1016/j.biopha.2024.116305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/06/2024] [Accepted: 02/17/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Through bioinformatics analysis, this study explores the interactions and biological pathways involving metabolomic products in patients diagnosed with coronary heart disease (CHD). METHODS A comprehensive search for relevant studies focusing on metabolomics analysis in CHD patients was conducted across databases including CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library, Nature, Web of Science, Springer, and Science Direct. Metabolites reported in the literature underwent statistical analysis and summarization, with the identification of differential metabolites. The pathways associated with these metabolites were examined using the Kyoto Encyclopedia of Genes and Genomes (KEGG). Molecular annotation of metabolites and their relationships with enzymes or transporters were elucidated through analysis with the Human Metabolome Database (HMDB). Visual representation of the properties related to these metabolites was achieved using Metabolomics Pathway Analysis (metPA). RESULTS A total of 13 literatures satisfying the criteria for enrollment were included. A total of 91 metabolites related to CHD were preliminarily screened, and 87 effective metabolites were obtained after the unrecognized metabolites were excluded. A total of 45 pathways were involved. Through the topology analysis (TPA) of pathways, their influence values were calculated, and 13 major metabolic pathways were selected. The pathways such as Phenylalanine, tyrosine, and tryptophan biosynthesis, Citrate cycle (TCA cycle), Glyoxylate and dicarboxylate metabolism, and Glycine, serine, and threonine metabolism primarily involved the regulation of processes and metabolites related to inflammation, oxidative stress, one-carbon metabolism, energy metabolism, lipid metabolism, immune regulation, and nitric oxide expression. CONCLUSION Multiple pathways, including Phenylalanine, tyrosine, and tryptophan biosynthesis, Citrate cycle (TCA cycle), Glyoxylate and dicarboxylate metabolism, and Glycine, serine, and threonine metabolism, were involved in the occurrence of CHD. The occurrence of CHD is primarily associated with the regulation of processes and metabolites related to inflammation, oxidative stress, one-carbon metabolism, energy metabolism, lipid metabolism, immune regulation, and nitric oxide expression.
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Affiliation(s)
- Chun Chu
- Department of Pharmacy, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan Province 421001, China
| | - Shengquan Liu
- Department of Cardiology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan Province 421001, China
| | - Liangui Nie
- Department of Cardiology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan Province 421001, China
| | - Hongming Hu
- Department of Cardiology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan Province 421001, China
| | - Yi Liu
- Department of Pharmacy, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan Province 421001, China.
| | - Jun Yang
- Department of Cardiology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan Province 421001, China.
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Patterson-Norrie T, Ramjan L, Sousa MS, Kezhekkekara S, George A. Oral health knowledge, attitudes and practices of dietitians in Australia: A national survey. Health Promot J Austr 2024. [PMID: 38192008 DOI: 10.1002/hpja.840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/18/2023] [Accepted: 12/22/2023] [Indexed: 01/10/2024] Open
Abstract
AIM Dietitians are a well-placed profession to be providing pre-emptive oral health promotion. Despite recommendations that oral health promotion should be routinely part of dietetic practice, there is limited data informing the current practices of clinical dietitians in this area across Australia. Hence, the aim of this study was to investigate the knowledge and practices of Australian dietitians and oral health promotion. METHODS A cross-sectional survey was undertaken involving registered clinical dietitians in Australia using purposive and snowballing sampling (social media/dietetic organisations/public databases). Data were analysed using descriptive and inferential statistics. RESULTS A total of 149 dietitians participated in the national survey. Overall, dietitians were knowledgeable about oral health risk factors and preventative measures across general health domains. Majority of dietitians agreed that oral health can affect nutrition interventions (95.5%) and dietitians should be discussing oral health (88.0%). However, nearly half were not confident in providing counselling or education and felt that undergraduate training for oral health promotion was inadequate (78.2%). A small proportion (6.0%) of dietitians were already providing oral health promotion regularly. Key barriers included a lack of clear guidelines for practice, limited training opportunities and indistinct referral pathways. CONCLUSION Dietitians have acknowledged that oral health promotion should be incorporated into their practice. However, they are challenged by a lack of resources and training to support this in clinical practice. SO WHAT?: Capacity building dietitians to promote oral health allows opportunity for improvement in the oral health, nutritional status and quality of life of priority population groups.
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Affiliation(s)
- Tiffany Patterson-Norrie
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Lucie Ramjan
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
| | - Mariana S Sousa
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- IMPACCT-Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Broadway, New South Wales, Australia
| | - Shwetha Kezhekkekara
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Ajesh George
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Lee SK, Hwang SY. Cardiovascular Health Behavior Prediction Model in Patients With Type 2 Diabetes. J Cardiovasc Nurs 2023:00005082-990000000-00124. [PMID: 37661310 DOI: 10.1097/jcn.0000000000001037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
BACKGROUND To prevent cardiovascular disease in adults with type 2 diabetes, it is necessary to identify the factors that affect cardiovascular health behavior. OBJECTIVE The aim of this study was to verify the causal relationship between illness perception and diabetes knowledge as cognitive representations, depression as emotional representations, self-efficacy as cognitive coping, and oral health and cardiovascular health behaviors as behavioral coping strategies. A hypothetical model was established based on a literature review and the self-regulation model. METHODS In this study, a cross-sectional survey design was used, and the participants were adults 30 years or older who had been given a diagnosis of type 2 diabetes for more than 6 months and were recruited from South Korea. Data from 272 participants were collected through face-to-face interviews or Google surveys in 2021, and analyzed using SPSS 25.0 and AMOS 22.0. RESULTS Oral health behavior (β = 0.26, P < .001) and self-efficacy (β = 0.16, P = .048) had a direct effect on cardiovascular health behavior, and illness perception (β = 0.24, P = .018) and depression (β = -0.25, P < .001) had an indirect effect through self-efficacy (β = 0.24, P = .016), with a total explanatory power of 19.1%. Oral health behavior was directly affected by illness perception and self-efficacy, and self-efficacy was directly affected by illness perception, diabetes knowledge, and depression (P < .05). CONCLUSION To practice cardiovascular health behaviors in adults with diabetes, self-efficacy for diabetes management should be enhanced. To this end, it is necessary to increase illness perception and knowledge, and reduce depression through cardiovascular disease prevention education for them, and the importance of oral health behaviors should also be emphasized.
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King S, Thaliph A, Laranjo L, Smith BJ, Eberhard J. Oral health literacy, knowledge and perceptions in a socially and culturally diverse population: a mixed methods study. BMC Public Health 2023; 23:1446. [PMID: 37507737 PMCID: PMC10375643 DOI: 10.1186/s12889-023-16381-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/25/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Poor oral health literacy has been proposed as a causal factor in disparities in oral health outcomes. This study aims to investigate oral health literacy (OHL) in a socially and culturally diverse population of Australian adults visiting a public dental clinic in Western Sydney. METHODS A mixed methods study where oral health literacy was assessed using the Health Literacy in Dentistry scale (HeLD-14) questionnaire and semi-structured interviews explored oral health related knowledge, perceptions and attitudes. Interviews were analysed using a thematic approach. RESULTS A sample of 48 participants attending a public dental clinic in Western Sydney was recruited, with a mean age of 59.9 (SD16.2) years, 48% female, 50% born in Australia, 45% with high school or lower education, and 56% with low-medium OHL. A subgroup of 21 participants with a mean age of 68.1 (SD14.6) years, 40% female, 64% born in Australia, 56% with a high school or lower education, and 45% with low-medium OHL completed the interview. Three themes identified from the interviews included 1) attitudes and perceptions about oral health that highlighted a lack of agency and low prioritisation of oral health, 2) limited knowledge and education about the causes and consequences of poor oral health, including limited access to oral health education and finally 3) barriers and enablers to maintaining good oral health, with financial barriers being the main contributor to low OHL. CONCLUSIONS Strategies aimed at redressing disparities in oral health status should include improving access to oral health information. The focus should be on the impact poor oral health has on general health with clear messages about prevention and treatment options in order to empower individuals to better manage their oral health.
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Affiliation(s)
- Shalinie King
- Westmead Applied Research Centre and the Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Ayesha Thaliph
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Liliana Laranjo
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Ben J Smith
- Sydney School of Public Health, and the Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Joerg Eberhard
- Sydney Dental School and the Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Knowledge, Attitudes and Practices of Indian Immigrants in Australia towards Oral Cancer and Their Perceived Role of General Practitioners: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148596. [PMID: 35886448 PMCID: PMC9319446 DOI: 10.3390/ijerph19148596] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/07/2022] [Accepted: 07/12/2022] [Indexed: 11/17/2022]
Abstract
Oral cancer is highly prevalent in the Indian subcontinent. With the increasing immigration of Indians to Australia, a potential rise in oral cancer cases can be expected if they continue engaging in oral cancer risk practices. Unfortunately, little is known on this topic in the Australian context. This study aimed to generate new insights into this area by examining Indian immigrants’ knowledge, attitudes and practices regarding oral cancer in Australia and their perceived role of general practitioners in raising oral cancer awareness. Exploring these aspects could determine the oral cancer risk behaviours of Indians in Australia along with any contributing factors which could help identify potential preventative strategies. A cross-sectional survey was undertaken of 164 Indians across Australia. Data were analysed using SPSS software with descriptive statistics. Respondents had varying levels of knowledge about oral cancer (mean total score 61%), particularly around risk factors such as alcohol and areca nut use as well as oral cancer-related signs/symptoms. The majority (87.7%) had not received any information about oral cancer in a health care setting but were receptive (71–90%) to general practitioners playing a more active role in this area. Respondents were engaging in positive preventative oral health care though few were currently (6.7%) or previously (14.7%) chewing tobacco preparations. Further research is needed through larger studies to confirm the study findings and inform the development of culturally tailored strategies particularly involving general practitioners, to raise oral cancer awareness and provide early screening for Indian immigrants.
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Akl S, Ranatunga M, Long S, Jennings E, Nimmo A. A systematic review investigating patient knowledge and awareness on the association between oral health and their systemic condition. BMC Public Health 2021; 21:2077. [PMID: 34772370 PMCID: PMC8590282 DOI: 10.1186/s12889-021-12016-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 10/13/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The prevalence of the oral-systemic relationship has accounted for potentially preventable chronic conditions and morbidity worldwide. Health literacy is a large contributing factor. This systematic review investigates the knowledge and awareness of patients with major systemic conditions, regarding the oral associations to their condition. METHODS Electronic databases including Medline (Ovid), CINAHL, The Cochrane Library, Web of Science, Informit Health Databases and Scopus were searched. All articles from 2011 to 2020, investigating knowledge of the oral-systemic link, of adult patients with the following major system conditions were searched: diabetes mellitus (DM), respiratory disease, cardiovascular disease (CVD), pregnancy and bone disease. Two independent reviewers completed screening, data extraction and quality assessment. A synthesis without meta-analysis was conducted. Twenty-four studies, from 14 different countries, were included in the systematic review. RESULTS Analysis showed that globally, patients with major systemic conditions have poor knowledge and awareness (< 50%) of the oral health associations to their condition. Improvements in health education are particularly necessary for patients with heart disease, bone disease and diabetes. Dentists and the media were the most common source of information. There were no relevant studies investigating the knowledge of patients with respiratory disease. CONCLUSION To improve the global burden of preventable chronic conditions, it is essential to address inequalities in the dissemination of health education to at-risk populations. Improvements in patient education rely on an increase in patient-practitioner communication on the oral-systemic link, implementation of oral health educational programs and greater interdisciplinary collaboration.
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Affiliation(s)
- Sabrina Akl
- College of Medicine and Dentistry, Cairns Campus, James Cook University, Cairns, QLD, 4878, Australia.
| | - Madusha Ranatunga
- College of Medicine and Dentistry, Cairns Campus, James Cook University, Cairns, QLD, 4878, Australia
| | - Sharron Long
- College of Medicine and Dentistry, Cairns Campus, James Cook University, Cairns, QLD, 4878, Australia
| | - Ernest Jennings
- College of Medicine and Dentistry, Cairns Campus, James Cook University, Cairns, QLD, 4878, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, 4878, Australia
- Centre for Molecular Therapeutics, James Cook University, Cairns, QLD, 4878, Australia
| | - Alan Nimmo
- College of Medicine and Dentistry, Cairns Campus, James Cook University, Cairns, QLD, 4878, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, 4878, Australia
- Centre for Molecular Therapeutics, James Cook University, Cairns, QLD, 4878, Australia
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Poudel P, Griffiths R, Arora A, Wong VW, Flack JR, Barker G, George A. Oral Health Status, Knowledge, and Behaviours of People with Diabetes in Sydney, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073464. [PMID: 33810479 PMCID: PMC8037358 DOI: 10.3390/ijerph18073464] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/22/2021] [Accepted: 03/25/2021] [Indexed: 12/15/2022]
Abstract
This study assessed self-reported oral health status, knowledge, and behaviours of people living with diabetes along with barriers and facilitators in accessing dental care. A cross sectional survey of 260 patients from four public diabetes clinics in Sydney, Australia was undertaken using a 35-item questionnaire. Data were analysed using SPSS software with descriptive and logistic regression analyses. More than half (53.1%) of respondents reported having dental problems which negatively impacted their related quality of life. Less than half (45%) had adequate oral health knowledge. Only 10.8% reported receiving any oral health information in diabetes care settings, which had higher odds of demonstrating adequate oral health knowledge (AOR, 2.60; 95% CI, 1.06-6.34). Similarly, 62.7% reported seeing a dentist in the last 12 months. Having private health insurance (AOR, 3.70; 95% CI, 1.85-7.40) had higher odds of seeing a dentist in the past 12 months. Dental costs were a major contributor to avoiding or delaying dental visit. Patients living with diabetes have unmet oral health needs particularly around the awareness of its importance and access to affordable dental services. Diabetes care providers can play a crucial role in this area by promoting oral health to their patients.
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Affiliation(s)
- Prakash Poudel
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool, NSW 2170, Australia;
- School of Nursing & Midwifery, Western Sydney University, Campbelltown, NSW 2560, Australia;
- South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; (V.W.W.); (J.R.F.)
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
- Correspondence:
| | - Rhonda Griffiths
- School of Nursing & Midwifery, Western Sydney University, Campbelltown, NSW 2560, Australia;
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Campbelltown, NSW 2751, Australia;
- Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW 2010, Australia
| | - Vincent W. Wong
- South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; (V.W.W.); (J.R.F.)
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
- Faculty of Medicine, University of New South Wales, Kensington, NSW 2052, Australia
| | - Jeff R. Flack
- South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; (V.W.W.); (J.R.F.)
- Faculty of Medicine, University of New South Wales, Kensington, NSW 2052, Australia
- Diabetes Centre Bankstown-Lidcombe Hospital, Bankstown, NSW 2200, Australia
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
| | - George Barker
- Diabetes Education Service, Hornsby-Ku-ring-gai Hospital, Northern Sydney Local Health District, Hornsby, NSW 2077, Australia;
| | - Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool, NSW 2170, Australia;
- School of Nursing & Midwifery, Western Sydney University, Campbelltown, NSW 2560, Australia;
- South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; (V.W.W.); (J.R.F.)
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia
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Impact of Oral Health Status on Postoperative Complications and Functional Recovery After Cardiovascular Surgery. CJC Open 2020; 3:276-284. [PMID: 33778444 PMCID: PMC7984977 DOI: 10.1016/j.cjco.2020.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 10/09/2020] [Indexed: 12/25/2022] Open
Abstract
Background Poor oral health status can lead to a deteriorated level of general health and is common among patients undergoing cardiovascular surgery. However, the effect of oral health status on postoperative outcomes in cardiovascular surgery patients remains unclear. Thus, we investigated the effect of preoperative oral health status on postoperative complications and functional recovery after cardiovascular surgery. Methods This single-centre retrospective cohort study included 884 inpatients undergoing elective cardiovascular surgery. Oral health status was assessed based on the number of remaining teeth, use of dentures, occlusal support, and periodontal status. We investigated postoperative complications related to surgery and postoperative functional recovery by measuring the reacquisition of walking ability, activities of daily living, and length of postoperative hospital stay. Results In this cohort (age 66.9 ± 13.4 years), the mean number of remaining teeth was 18.7 ± 9.4. Patients were grouped based on tertiles of the data distribution of remaining teeth: ≥ 20 teeth (470 patients); 10-19 teeth (137 patients); < 10 teeth (185 patients). The number of missing teeth was associated with age (P < 0.001). The prevalence of postoperative pneumonia and reintubation after surgery was 3.2% and 2.5%, respectively, which was significantly higher in patients with severe tooth loss (P < 0.05 for both). After adjusting for age and other confounding factors, the number of remaining teeth was a statistically significant predictor of functional recovery (P < 0.05). Conclusions Preoperative oral health status was related to postoperative respiratory complications and independently associated with functional recovery. Preoperative oral intervention may improve functional recovery after cardiovascular surgery.
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