People who get periodontal care fare better after heart attack

People who have received periodontal maintenance care stayed in the hospital for the shortest time after a heart attack, a new study shows.

The conventional wisdom is that medical and dental care are related, but less is known about how dental care relates to health outcomes after acute incidents like heart attacks.

To that end, researchers studied patients receiving periodontal care, dental cleanings, or no dental care during 2016-2018 and who had a heart attack (acute myocardial infarction) in 2017.

In addition to the shorter length of hospital stay, the researchers also found that patients who had periodontal care also had more follow-up visits after a heart attack.

People in the no-dental-care group had the longest length of stay.

“After controlling for several factors, the periodontal care group had higher odds of having post-hospital visits,” says Romesh Nalliah, associate dean for patient services at the University of Michigan School of Dentistry and coauthor of the study in the Journal of the American Dental Association.

There was no statistically significant difference between the other groups (active periodontal care and regular care) compared to the no-care group.

The study did not establish a causal relationship between periodontal disease and heart disease, but research like this adds weight to the understanding that there is an association between oral health and overall health, Nalliah says.

There are 800,000 myocardial infarctions in the United States annually, and those with periodontal disease are at increased risk for hospitalization after a heart attack, he says.

Nalliah and colleagues wanted to examine the association between periodontal care and heart attack hospitalization, and follow-up visits in the 30 days after acute care.

Using the MarketScan database, they found 2,370 patients who fit the study criteria. Of those, 47% received regular or other oral health care, 7% received active periodontal care (root planing and periodontal scaling), and 10% received controlled periodontal care (maintenance). More than 36% did not have oral health care before they were hospitalized after a heart attack.

“Dentistry is often practiced in isolation from overall health care,” Nalliah says. “Our results add weight to the evidence that medical and dental health are closely interrelated. More and more studies like ours are showing that it is a mistake to practice medicine without the thoughtful consideration of the patient’s oral health.”

Improved communication between medical and dental teams could help with early intervention to ensure stable periodontal health in patients who have risk factors for heart disease, Nalliah says.

“It is important to include dental care in routine medical care and this means insurances must facilitate this connection rather than offer dental insurance as a separate add-on coverage.”

Additional coauthors are from the Michigan Hospital Medicine Safety Consortium and Michigan Medicine.

Source: University of Michigan

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