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Schmalz G, Hennecke A, Haak R, Kottmann T, Garbade J, Binner C, Ziebolz D. Secondary analysis of potential associations between oral health and infection-related parameters in patients with severe heart failure-results of a German cohort. BMC Cardiovasc Disord 2023; 23:573. [PMID: 37990175 PMCID: PMC10664670 DOI: 10.1186/s12872-023-03612-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVES Aim of this retrospective cohort study was to evaluate whether oral health parameters would be associated with infection-related parameters and overall survival of patients with severe heart failure (HF). METHODS Patients with severe HF, heart transplantation (HTx) and left-ventricular assist device (LVAD), which underwent a full oral examination between 2017 and 2018 were included. Infection-related and survival data were assessed from the patient´s medical records. The oral examination included: remaining teeth, caries and periodontal condition, including periodontal probing depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), and diagnosis (staging/grading). In addition, the periodontal inflamed surface area (PISA) was determined. Statistical analysis included Chi-square, Fisher´s exact and Mann-Whitney-U test, as well as a logistic regression, considering age, gender, body-mass-index (BMI), diabetes and several oral health parameters with regard to overall survival and infections at heart/driveline. RESULTS 329 patients (HTx: 34%, LVAD: 38.9%, HF: 27.1%), were included. Patients had on average 18.96 ± 8.90 remaining teeth, whereby the majority had a periodontitis stage III or IV (88.7%) and a grade B (80.5%). Higher BOP was associated with infections at heart/driveline (p = 0.04) and outside the heart (p < 0.01) during follow-up. Increased PISA was significantly associated with bacterial infections outside the heart (p < 0.01) and sepsis (p = 0.02). Only BMI of 25 or higher correlated with an increased risk of infections at heart/driveline in regression analysis (OR 3.063, CI95 1.158-8.101, p = 0.02), while no associations between oral health parameters and infections at heart/driveline or overall survival were confirmed. CONCLUSIONS In patients with severe HF, periodontal inflammation might be associated with infection-related parameters. Improved dental care, especially including periodontal therapy and maintenance might be favourable to support prevention of infections in patients with severe HF.
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Affiliation(s)
- Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, D 04103, Leipzig, Germany.
| | - Alina Hennecke
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, D 04103, Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, D 04103, Leipzig, Germany
| | | | - Jens Garbade
- Department of Cardiac Surgery, Klinikum Links der Weser, 28277, Bremen, Germany
| | - Christian Binner
- University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, D 04103, Leipzig, Germany
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Schmalz G, Lenzen C, Reuschel F, Fenske F, Haak R, Goralski S, Roth A, Ziebolz D. Lack of oral health awareness and interdisciplinary dental care: a survey in patients prior to endoprosthesis and orthopaedic centres in Germany. BMC Oral Health 2023; 23:92. [PMID: 36782181 PMCID: PMC9926854 DOI: 10.1186/s12903-023-02793-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/06/2023] [Indexed: 02/15/2023] Open
Abstract
OBJECTIVES This cross-sectional survey aimed to evaluate the oral health behaviour of patients prior to endoprosthesis (EP), as well as the handling of oral health topics by German orthopaedic surgeons. MATERIALS AND METHODS Consecutive patients prior to EP answered a questionnaire regarding oral health behaviour, oral hygiene, oral complaints and information on the relationship between EP and oral health. Another questionnaire was digitally mailed to orthopaedic centres throughout Germany. This questionnaire included the importance of oral health for EP and issues on dental referrals/consultations prior to EP. RESULTS A total of 172 patients were included in the study, of whom 35.5% of patients reported that they were informed about oral health and EP. Half of the individuals reported regular professional tooth cleaning, and less than one-third (29.1%) reported of the performance of interdental cleaning. Information on oral health and EP was associated with regular professional tooth cleaning (yes: 59.8% vs. no: 35.6%, p = 0.01). A total of 221 orthopaedic clinics were included in the study, of which only a few had dental contact (14%), although the majority (92.8%) of the clinics were familiar with causal relationships between oral health and EP infections. Less than half of the centres reported of either verbal (48%) or written (43.9%) referrals for their patients to the dentist. University Medical Centres reported of more frequent dental contacts (p < 0.01). CONCLUSION Prior to EP, patients exhibited deficits in oral health behaviour, and orthopaedic clinics exhibited a lack of dental collaboration. Improvements in interdisciplinary care, especially regarding practical concepts for patient referral and education on oral health, appear to be necessary.
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Affiliation(s)
- Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University Medical Center Leipzig, University of Leipzig, Liebigstr. 10-14, 04103, Leipzig, Germany.
| | - Carina Lenzen
- grid.9647.c0000 0004 7669 9786Department of Cariology, Endodontology and Periodontology, University Medical Center Leipzig, University of Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
| | - Florentine Reuschel
- grid.9647.c0000 0004 7669 9786Department of Cariology, Endodontology and Periodontology, University Medical Center Leipzig, University of Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
| | - Fabian Fenske
- grid.9647.c0000 0004 7669 9786Department of Craniomaxillofacial Surgery, University of Leipzig, Leipzig, Germany
| | - Rainer Haak
- grid.9647.c0000 0004 7669 9786Department of Cariology, Endodontology and Periodontology, University Medical Center Leipzig, University of Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
| | - Szymon Goralski
- grid.411339.d0000 0000 8517 9062Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Andreas Roth
- grid.411339.d0000 0000 8517 9062Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Dirk Ziebolz
- grid.9647.c0000 0004 7669 9786Department of Cariology, Endodontology and Periodontology, University Medical Center Leipzig, University of Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
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Schröter U, Ziebolz D, Stepan H, Schmalz G. Oral hygiene and oral health behavior, periodontal complaints and oral health-related quality of life in pregnant women. BMC Oral Health 2022; 22:476. [DOI: 10.1186/s12903-022-02508-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022] Open
Abstract
Abstract
Objectives
This questionnaire-based cross-sectional study aimed in the evaluation of oral hygiene and oral health behavior, periodontal complaints and oral health-related quality of life (OHRQoL) in pregnant women in southwest-Saxony, Germany.
Materials and methods
Consecutive patients attending the clinics for Obstetrics and Gynecology, Heinrich-Braun-Klinikum Zwickau, Germany, were recruited in the years 2020 and 2021. The evaluation consisted of three parts: (I) dental and oral hygiene behavior, (II) periodontal complaints and (III) German short form of oral health impact profile (OHIP G14) to assess OHRQoL.
Results
853 out of 1056 participants were included in the study. The pregnant women reported that they have received information on oral health during pregnancy more often from gynecologists than from dentists. Slightly more than half of the participants (51.5%) rated to regularly undergo a professional tooth cleaning. Similarly, nearly half of the women stated to perform interdental cleaning (55.8%). The most common periodontal complaint was bleeding of the gums (45.4%). The OHIP G14 findings of all questions as well as sum scores showed a median of 0. Regression analysis revealed that regular professional tooth cleaning was a predictor of better OHRQoL (β – 0.698, CI95 0.049–1.299; p < 0.04).
Conclusion
Oral hygiene and oral health behavior of pregnant women in southwest-Saxony requires improvement. While the overall OHRQoL of the cohort was not reduced, professional tooth cleaning and thus professional preventive measures can support OHRQoL during pregnancy. Improved interdisciplinary oral health care concepts for pregnant women should be fostered. These concepts can also positively influence OHRQoL issues.
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Schmalz G, Zöbisch SP, Garbade J, Rast J, Eisner M, Wagner J, Kottmann T, Binner C, Eifert S, Ziebolz D. No Association between Clinical Periodontal Conditions and Microbiological Findings on Driveline of Patients with Left-Ventricular Assist Devices (LVAD). Antibiotics (Basel) 2021; 10:antibiotics10101219. [PMID: 34680800 PMCID: PMC8532916 DOI: 10.3390/antibiotics10101219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this retrospective study was to investigate whether there would be an association between periodontal disease parameters and positive bacterial findings at the driveline of patients with a left ventricular assist device (LVAD). Patients with an LVAD, who underwent a full oral and microbiological examination between 2016 and 2018, were included. During oral examination, periodontitis severity (stage and grade) and the periodontal inflamed surface area (PISA) were evaluated. A microbiological analysis was performed from swabs of the driveline, whereby different bacterial species were cultivated and analyzed. A total of 73 patients were included in the current study. The majority of participants (80.8%) had at least one positive bacterial finding during the study period. Most patients had a periodontitis stage of III-IV (80.9%). The determined PISA of the total group was 284.78 ± 352.29 mm2. No associations were found between the periodontal disease parameters and the bacterial findings in general, the bacterial findings on the day of oral examination or the bacterial findings 12 months prior to/after the oral examination (p > 0.05). Periodontitis is not associated with cultivated microbiological findings at the driveline of patients with an LVAD and thus appears not to be a risk indicator for driveline colonization. Nevertheless, the high periodontal burden in LVAD patients underlines the need for their improved periodontal care.
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Affiliation(s)
- Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (G.S.); (S.-P.Z.); (J.R.); (M.E.); (J.W.)
| | - Sven-Paul Zöbisch
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (G.S.); (S.-P.Z.); (J.R.); (M.E.); (J.W.)
| | - Jens Garbade
- Department of Cardiac Surgery, Klinikum Links der Weser, 28277 Bremen, Germany;
| | - Josephine Rast
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (G.S.); (S.-P.Z.); (J.R.); (M.E.); (J.W.)
| | - Mirjam Eisner
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (G.S.); (S.-P.Z.); (J.R.); (M.E.); (J.W.)
| | - Justus Wagner
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (G.S.); (S.-P.Z.); (J.R.); (M.E.); (J.W.)
| | - Tanja Kottmann
- CRO Dr. med. Kottmann GmbH & Co. KG, 59077 Hamm, Germany;
| | - Christian Binner
- Department of Cardiac Surgery, Heart Center Leipzig, 04289 Leipzig, Germany; (C.B.); (S.E.)
| | - Sandra Eifert
- Department of Cardiac Surgery, Heart Center Leipzig, 04289 Leipzig, Germany; (C.B.); (S.E.)
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (G.S.); (S.-P.Z.); (J.R.); (M.E.); (J.W.)
- Correspondence: ; Tel.: +0049-341-9721211
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Schmalz G, Garbade J, Sommerwerck U, Kollmar O, Ziebolz D. 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. Med Oral Patol Oral Cir Bucal 2021; 26:e437-e444. [PMID: 33340076 PMCID: PMC8254886 DOI: 10.4317/medoral.24277] [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: 08/26/2020] [Accepted: 11/30/2020] [Indexed: 01/02/2023] Open
Abstract
Background This multicentre cross-sectional study aimed in examination of oral health-related quality of life (OHRQoL) of patients after solid organ transplantation (SOT).
Material and Methods Patients after SOT (liver, lung and heart) at one out of three German centers (Goettingen, Essen, Leipzig) were included. For comparison, a healthy control (HC) was recruited. OHRQoL was assessed by German short form of oral health impact profile (OHIP G14). Oral examination comprised: decayed-, missing- and filled-teeth index (DMF-T), remaining teeth and periodontitis severity.
Results In total, 196 patients after SOT and 130 HC with comparable age, gender and smoking habits were included (p>0.05). DMF-T and number of remaining teeth was worse in SOT group (p<0.01). OHIP G14 sum score was significantly higher in SOT (3.49 ± 5.73 vs. 1.33 ± 2.63, p<0.01). In contrast to HC, in SOT no associations between OHIP G14 and oral health parameters were found (p>0.05). Number of remaining teeth was not an independent predictor of OHIP G14 sum score in SOT (β -0.082, CI95 -0.156 - 0.045, p=0.28).
Conclusions OHRQoL of SOT recipients is not affected by their oral condition, leading to the assumption that the individual perception of patients physical oral health is not in line with the clinical situation. Key words:Oral health, oral health-related quality of life, solid organ transplantation.
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Affiliation(s)
- G Schmalz
- University Leipzig Dept. of Cariology, Endodontology and Periodontology Liebigstr. 12, D 04103 Leipzig, Germany
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Ziebolz D, Binner C, Reuschel F, Eisner M, Wagner J, Kottmann T, Etz CD, Lehmann S, Garbade J, Schmalz G. Comparison of periodontal parameters between patients with ischemic and dilative cardiomyopathy. BMC Cardiovasc Disord 2021; 21:304. [PMID: 34134635 PMCID: PMC8207630 DOI: 10.1186/s12872-021-02111-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/09/2021] [Indexed: 12/11/2022] Open
Abstract
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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Affiliation(s)
- Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Christian Binner
- University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Florentine Reuschel
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Mirjam Eisner
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Justus Wagner
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | | | - Christian D Etz
- University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Sven Lehmann
- University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany.,Department of Cardiac Surgery, Klinikum Links der Weser, Bremen, Germany
| | - Jens Garbade
- University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany.,Department of Cardiac Surgery, Klinikum Links der Weser, Bremen, Germany
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany.
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Effect of periodontal treatment on the glomerular filtration rate, reduction of inflammatory markers and mortality in patients with chronic kidney disease: A systematic review. PLoS One 2021; 16:e0245619. [PMID: 33481920 PMCID: PMC7822280 DOI: 10.1371/journal.pone.0245619] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 01/04/2021] [Indexed: 12/12/2022] Open
Abstract
Aim To assess the effect of periodontal treatment (PT) on glomerular filtration rate (GFR), systemic inflammation, or mortality in patients with chronic kidney disease (CKD). Methods A literature search was performed on PubMed and Web of Science databases on articles published until December 2019. The PRISMA guidelines were used throughout the manuscript. Results Of the total studies found, only 18 met the inclusion criteria; four retrospective and 14 prospective studies (including 3 randomized controlled trials–RCT). After PT, 3 studies investigated GFR, 2 found significant improvement; 11 (including 2 RCTs) investigated C-reactive protein levels, 9 found a significant improvement (including the 2 RCTs); 5 (including 3 RCTs) investigated Interleukine-6 level, 4 found a significant improvement (including 2 RCTs) and 2 studies evaluated mortality, one (retrospective study) found a significant difference. Conclusions Within the limitations of the present study, PT seems to improve CKD status, especially by reducing the systemic inflammation. Further RCTs are needed to confirm the results and specifically assess the influence of different types of PT in CKD patients. Taking into consideration the ability of PT to prevent further tooth loss and denutrition, early management of periodontitis is extremely important in patients with impaired renal function.
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Schmalz G, Garbade J, Kollmar O, Ziebolz D. Does oral health-related quality of life of patients after solid organ transplantation indicate a response shift? Results of a systematic review. BMC Oral Health 2020; 20:356. [PMID: 33298051 PMCID: PMC7726902 DOI: 10.1186/s12903-020-01350-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/26/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The physical oral health and dental behaviour of patients after solid organ transplantation (SOT) has repeatedly been reported as insufficient. The objective of this systematic review was to detect whether the oral health-related quality of life (OHRQoL) of patients after SOT is reduced compared to that of healthy individuals. METHODS A systematic literature search was performed by two independent individuals based on the PubMed, Web of Science and Scopus databases by using the following search terms: "transplantation" AND "oral health-related quality of life". The findings were checked to determine eligibility, whereby publication prior to 31 October 2020, examination of adult patients (age at least 18 years) with SOT, reporting of an OHRQoL outcome and full text in English language were the prerequisites for inclusion in the qualitative analysis. Quality appraisal of the included studies was performed using the Agency for Healthcare Research and Quality methodology checklist. RESULTS Seven of 25 studies that examined patients after kidney (3), heart (2), liver (1) and lung transplantation (1) were included. Four studies included healthy controls, and five studies included a cohort of patients before transplantation for comparison. Clinical oral health examinations were heterogeneous between groups. The majority of studies (5/7) applied the short form of the "Oral Health Impact Profile" (OHIP 14) to assess OHRQoL. The OHIP 14 values ranged between 1.7 and 8.9 across studies, indicating an unaffected or just slightly reduced OHRQoL. Only one study found better OHRQoL in patients after SOT compared to a group before SOT, and one study confirmed worse OHRQoL of SOT recipients compared to a healthy control. Only two studies revealed an association between OHRQoL and oral health parameters. Furthermore, two studies each found a relationship between OHRQoL and general health-related quality of life or disease-related parameters. CONCLUSIONS Patients after SOT show an unaffected or only slightly reduced OHRQoL, which was mainly independent of the insufficient oral status. This might indicate a shift in the perception threshold for oral diseases and conditions caused by the general health burden related to the SOT.
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Affiliation(s)
- Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany.
| | - Jens Garbade
- University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Otto Kollmar
- Universitäres Bauchzentrum Basel, Universitätsspital Basel, Basel, Switzerland
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
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Garbade J, Rast J, Schmalz G, Eisner M, Wagner J, Kottmann T, Oberbach A, Lehmann S, Haak R, Borger MA, Binner C, Ziebolz D. Oral health and dental behaviour of patients with left ventricular assist device: a cross-sectional study. ESC Heart Fail 2020; 7:1273-1281. [PMID: 32027102 PMCID: PMC7261540 DOI: 10.1002/ehf2.12636] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/08/2020] [Accepted: 01/21/2020] [Indexed: 12/26/2022] Open
Abstract
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 from the University Department for Cardiac Surgery at Heart Center, Leipzig, Germany. 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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Affiliation(s)
- Jens Garbade
- University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Josephine Rast
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, Leipzig, D 04103, Germany
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, Leipzig, D 04103, Germany
| | - Mirjam Eisner
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, Leipzig, D 04103, Germany
| | - Justus Wagner
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, Leipzig, D 04103, Germany
| | | | - Andreas Oberbach
- Department of Diagnostics, Fraunhofer Institute for Cell Therapy and Immunology Leipzig, Leipzig, Germany
| | - Sven Lehmann
- University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, Leipzig, D 04103, Germany
| | - Michael A Borger
- University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Christian Binner
- University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, Leipzig, D 04103, Germany
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Ziebolz D, Friedrich S, Binner C, Rast J, Eisner M, Wagner J, Schmickler J, Kottmann T, Haak R, Borger MA, Lehmann S, Oberbach A, Garbade J, Schmalz G. Lack in Periodontal Care of Patients Suffering from Severe Heart Diseases-Results after 12 Months Follow-Up. J Clin Med 2020; 9:jcm9020352. [PMID: 32012698 PMCID: PMC7073650 DOI: 10.3390/jcm9020352] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 01/16/2020] [Accepted: 01/23/2020] [Indexed: 12/15/2022] Open
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.
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Affiliation(s)
- Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (S.F.); (J.R.); (M.E.); (J.W.); (J.S.); (R.H.); (G.S.)
- Correspondence: ; Tel.: +49-341-97-21211
| | - Sylvia Friedrich
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (S.F.); (J.R.); (M.E.); (J.W.); (J.S.); (R.H.); (G.S.)
| | - Christian Binner
- University Department of Cardiac Surgery, Heart Center Leipzig, 04289 Leipzig, Germany; (C.B.); (M.A.B.); (S.L.); (J.G.)
| | - Josephine Rast
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (S.F.); (J.R.); (M.E.); (J.W.); (J.S.); (R.H.); (G.S.)
| | - Mirjam Eisner
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (S.F.); (J.R.); (M.E.); (J.W.); (J.S.); (R.H.); (G.S.)
| | - Justus Wagner
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (S.F.); (J.R.); (M.E.); (J.W.); (J.S.); (R.H.); (G.S.)
| | - Jan Schmickler
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (S.F.); (J.R.); (M.E.); (J.W.); (J.S.); (R.H.); (G.S.)
| | - Tanja Kottmann
- CRO Dr. med. Kottmann GmbH & Co. KG, 59077 Hamm, Germany;
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (S.F.); (J.R.); (M.E.); (J.W.); (J.S.); (R.H.); (G.S.)
| | - Michael A. Borger
- University Department of Cardiac Surgery, Heart Center Leipzig, 04289 Leipzig, Germany; (C.B.); (M.A.B.); (S.L.); (J.G.)
| | - Sven Lehmann
- University Department of Cardiac Surgery, Heart Center Leipzig, 04289 Leipzig, Germany; (C.B.); (M.A.B.); (S.L.); (J.G.)
| | - Andreas Oberbach
- Department of Diagnostics, Fraunhofer Institute for Cell Therapy and Immunology, 04103 Leipzig, Germany;
| | - Jens Garbade
- University Department of Cardiac Surgery, Heart Center Leipzig, 04289 Leipzig, Germany; (C.B.); (M.A.B.); (S.L.); (J.G.)
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (S.F.); (J.R.); (M.E.); (J.W.); (J.S.); (R.H.); (G.S.)
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