Prevalence of Periodontal Disease among Patients at the Outpatient Clinic of Internal Medicine in an Academic Hospital in The Netherlands: A Cross-Sectional Pilot Study

Abstract

There is a worldwide increase in individuals suffering ≥ 2 chronic diseases (multimorbidity), and the cause of combinations of conditions remains largely unclear. This pilot study analysed the prevalence of periodontal disease (PD) among (multi)-morbid patients at the outpatient clinic of internal medicine. PD is an inflammatory disease of the tooth supporting tissues and has a negative impact on the overall health. Data were obtained from 345 patients, on demographics, systemic conditions and presence of PD. The possible differences in the distribution of PD status among patients with/without multimorbidity and Medical Subject Headings (MeSH) disease chapters were explored. In total, 180 (52.2%) patients suffered from multimorbidity. The prevalence of severe PD was 16.2%, while the prevalence of mild and severe PD combined (Total PD) was 53.6%. Patients with disease chapter cardiovascular diseases (CVD) had a significantly higher prevalence of severe PD (odds ratio (OR) 2.33; 95% confidence interval (CI) 1.25, 4.33) and Total PD (OR 1.61; 95% CI 1.04, 2.50) than patients without CVD. After subsequent analyses, myocardial infarction was significantly associated with severe PD (OR: 4.68 (95% CI; 1.27 to 17.25)). Those suffering from multimorbidity showed to have a non-significant increased risk for severe (OR 1.27; 95% CI 0.69, 2.34) or Total PD (OR 1.23; 95% CI 0.81, 1.88). In conclusion, PD is highly prevalent in multimorbidity patients. Furthermore, PD was significantly prevalent in patients with CVD. However, larger epidemiological studies are necessary to confirm that the prevalence of PD is significantly increased among multimorbid patients.

Psychological Stress and its relationship to Periodontal flora and salivary Nitrite/Nitrate

“… 5 , 6 , 7 Previous research has shown the role of stress hormones on growth of selected periodontitis-related bacteria, 6 and evidence shows that NO deficiency at the endothelial level may be associated with the development of hypertension and other forms of cardiovascular disease. 7 Moreover, periodontal and cardiovascular diseases have been linked, 8 , 9 , 10 , 11 which preempts a hypothesis of a linkage amongst stress, periodontal disease, oral microbiota, and systemic homeostasis. According to different authors, academic stress is an important psychosocial challenge for both students and undergraduates, 12 and the role of academic stress has already been studied with regards to oral NO levels.…”

Relationship of Medication Intake and Systemic Conditions with Periodontitis: A Retrospective Study

“…Tobacco, alcohol, medications, uncontrolled diabetes and obesity have been suggested as factors that should be taken into consideration for a personalized care model for the management of periodontal diseases [13]. In a cross-sectional pilot study from the Netherlands, periodontal disease was highly prevalent in multimorbidity patients, and significant associations were found in patients with cardiovascular diseases [14]. Systemic inflammatory conditions including hypertension, arthritis, asthma, diabetes and HIV were also found to be significantly associated with the severity of bone loss as well as diabetes, lupus and the extent of missing teeth in a retrospective study that included 4890 randomly selected patients [15].…”

The Relationship between Severity of Periodontitis and Atherosclerotic Cardiovascular Status in Patients with Acute Myocardial Infarctions: A Cross-sectional Study

“…Severe PD is recognized as the primary cause of extensive tooth loss and complete toothlessness (edentulism) among adults worldwide 3) . PD has been reported to be associated with atherosclerotic cardiovascular (ASCV) diseases, such as acute myocardial infarction (AMI) 4) and ischemic stroke 5) . In patients with PD, they had higher values of low-density lipoprotein (LDL) cholesterol and high-sensitivity Creactive protein 6) .…”