Evaluation of oral health condition in patients at risk for endocarditis
DOI:
https://doi.org/10.35699/2178-1990.2023.42722Keywords:
Endocarditis, bacterial, Oral hygiene, Dental care, Oral healthAbstract
Aim: To assess the oral health status of patients at high risk of developing infective endocarditis treated at a referral hospital in Brazil.
Methods: Secondary data obtained from medical records of patients admitted to the cardiology ward of Hospital Dom Pedro II were used. Data were collected using a standardized form based on the patients’ dental evolution, in which the information obtained in the consultation was contained in the medical record, as well as the oral health information was recorded. After collection, the data were categorized into high and low risk of endocarditis and analyzed using Pearson’s chi-square test or Fisher’s exact test, considering a confidence interval of 95%.
Results: A total of 583 medical records of adults admitted to the cardiology ward from January 2017 to August 2020 were analyzed. Of these, 216 medical records were included in the study sample. The prevalence of infective endocarditis was 11.5% (n =18), and the risk of infective endocarditis was considered high for the majority (n = 196; 93.3%). Oral complaints were reported by 15.1% (n = 30), and oral hygiene was considered deficient for most patients (n = 95; 48.7%). The need for dental treatment was verified in 66.5% of the sample (n = 119).
Conclusion: The oral health status of patients with cardiac conditions predisposing to endocarditis infection is not satisfactory. A considerable portion needs invasive treatment, which increases the risk of bacteremia.
Downloads
References
Iversen KH, Rasmussen LH, Al-Nakeeb K, Armenteros JJA, Jensen CS, Dargis R, et al. Similar genomic patterns of clinical infective endocarditis and oral isolates of Streptococcus sanguinis and Streptococcus gordonii. Sci Rep. 2020; 10 (1): 2728.
Lima HG, Lara VS. Aspectos imunológicos da doença periodontal inflamatória: participação dos mastócitos. Cient Ciênc Biol Saúde. 2013; 15 (3): 225-9.
Cahill TJ, Prendergast BD. Infective endocarditis. Lancet. 2016; 27: 882-93.
Nascimento ER, Gonçalves JR, Neto-Filho MA, Oliveira RCG. Endocardite bacteriana em odontologia: doença e profilaxia medicamentosa. UNINGÁ Review. 2012; 12 (2): 136-45.
Lockhart PB, Brennan MT, Sasser HC, Fox PC, Paster BJ, Bahrani-Mougeot FK. Bacteremia associated with toothbrushing and dental extraction. Circulation. 2008; 17: 3118–25.
Widmer E, Que YA, Entenza JM, Moreillon P. New concepts in the pathophysiology of infective endocarditis. Curr Infect Dis Rep. 2006; 8:271–9.
Wallace SM, Walton BI, Kharbanda RK, Hardy R, Wilson AP, Swanton RH. Mortality from infective endocarditis: clinical predictors of outcome. Heart. 2002; 88:53-0.
Iversen K, Ihlemann N, Gill SU, Madsen T, Elming H, Jensen KT, et al. Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis. N Engl J Med. 2019; 380 (5):415-24.
Wahl MJ, Pallasch TJ. Dentistry and endocarditis. Curr Infect Dis Rep. 2005; 7:251-6.
Yew HS, Murdoch DR. Global trends in infective endocarditis epidemiology. Curr Infect Dis Rep. 2012; 14:367–72.
Quadros DRP, Fried H, Cesario PC. A endocardite infecciosa e o tratamento periodontal em pacientes de risco. Rev Bras Odontol. 2009; 66(2):197-201.
Cangussu PM, Araújo TDF, Soares WD, Almeida PNM. Endocardite bacteriana de origem bucal: revisão de literatura. Rev Bras Pesq Ciênc Saúde. 2015; 1(1):11-3.
Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2007;116(15):1736-54.
Amaral COF, Pereira LC, Guy NA, Amaral Filho MSP, Logar GA, Straioto FG. Oral health evaluation of cardiac patients admitted to cardiovascular pre-surgery intervention. Rev Gaúch Odontol. 2016; 64(4):419-424.
Rosa MRM de la, Catellanos-Cosano L, Romero-Perez MJ, Cutando A. The bacteremia of dental origin and its implications in the appearance of bacterial endocarditis. Med Oral Patol Oral Cir Bucal, 2014; 19(1): e67-74.
Holland T, Badour LM, Bayer AS, Hoen B, Miro JM, Fowler Jr VG. Infective endocarditis. Nat Rev Dis Primers. 2016; 2:16059.
Kumar A, Rai A. Oral health status, health behaviour and treatment needs of patients undergoing cardiovascular surgery. Braz J Cardiovasc Surg. 2018; 33(2): 151-154.
Lamont RJ, Koo H, Hajishengallis G. The oral microbiota: dynamic communities and host interactions. Nat Rev Microbiol. 2018; 16(12):745-759.
Dentino A, Lee S, Mailhot J, Hefti AF. Principles of periodontology. Periodontol 2000. 2013; 61(1):16–53.
Colombo APV, Magalhães CB, Hartenbach FARR, Souto RM, Silva-Boghossian CM. Periodontal-disease-associated biofilm: A reservoir for pathogens of medical importance. Microb Pathog. 2016; 94:27-34.
Tomás I, Diz P, Tobías A, Scully C, Donos N. Periodontal health status and bacteraemia from daily oral activities: systematic review / metaanalysis. J Clin Periodontol. 2012; 39(3):213-28.
Hao Y, Huang X, Zhou X, Li M, Ren B, Peng X, et al. Influence of Dental Prosthesis and Restorative Materials Interface on Oral Biofilms. Int J Mol Sci. 2018;19(10):3157.
Venditti M. Clinical aspects of invasive candidiasis: endocarditis and other localized infections. Drugs. 2009; 69:39-43.
Arnold CJ, Johnson M, Bayer AS, Bradley S, Giannitsioti E, Miró JM, et al. Candida infective endocarditis: an observational cohort study with a focus on therapy. Antimicrob Agents Chemother. 2015;59(4):2365-73.
