Oral health and dental behaviour of patients with left ventricular assist device: a cross‐sectional study

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 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.

Comparison of periodontal parameters between patients with ischemic and dilative cardiomyopathy

“…Alongside with the potential relationship between periodontal and cardiovascular diseases [ 5 ], a high periodontal burden in severely heart diseased patients appears plausible. The high periodontal burden and treatment need of patients with severe HF, after LVAD and/or HTx has been reported previously and appears an expectable finding [ 9 – 11 ].…”

“…Patients with advanced HF, especially if treated with either LVAD or HTx were recently reported to show a lack in periodontal care [ 9 – 11 ]. Thereby, a high periodontal treatment need, alongside with more severe periodontal disease burden was found in these individuals [ 9 – 11 ]. This might be hazardous, because this patient group is a vulnerable clientele, especially if treated with an HTx [ 12 ].…”

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

“…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].…”

“…Against this background, the potential role of periodontal inflammation as a risk factor for the development of LVADrelated infections appears to be a plausible option. Only one previous study examined a potential relationship between (history of) driveline infection and oral health conditions and failed to confirm a relationship [9]. However, no previous study has investigated whether there would be an association between periodontal disease severity as well as inflammation and positive microbiological findings at the driveline of LVAD.…”

Corrigendum

“…In the original published version of the paper Garbade et al ., 1 reference Binner et al (2019) should have been placed as reference 11. The online version has been modified to reflect the correct order of the references as shown below: Prinzing A, Herold U, Berkefeld A, Krane M, Lange R, Voss B.…”