The oral health status, behaviours and knowledge of patients with cardiovascular disease in Sydney Australia: a cross-sectional survey.

BACKGROUND: Periodontal disease is a risk factor for atherosclerotic cardiovascular disease and it is recommended internationally that patients with cardiovascular disease should engage in preventative oral health practices and attend regular dental care visits. This study aimed to explore the oral health status, behaviours and knowledge of patients with cardiovascular disease. METHODS: A cross-sectional questionnaire containing 31 items was administered to patients with cardiovascular disease from cardiac rehabilitation and outpatient clinics in Sydney Australia in 2016-2017. RESULTS: Of the 318 patients surveyed, 81.1% reported having at least one oral health problem. Over a third (41.2%) of participants had not seen a dentist in the preceding 12 months and 10.7% had received any oral healthcare information in the cardiac setting. Those with valvular conditions were more likely to have received information compared to those with other cardiovascular conditions (40.6% versus 7.4%, p < 0.001). Only half of the participants had adequate oral health knowledge. CONCLUSIONS: Despite a high incidence of reported oral health problems, many patients lacked knowledge about oral health, were not receiving oral health information from cardiac care providers and had difficulty accessing dental services. Further research is needed to develop oral health strategies in this area.

Oral health and cardiovascular care: Perceptions of people with cardiovascular disease.

MAIN OBJECTIVE: The aim of this study was to explore the perception of patients with cardiovascular disease towards oral health and the potential for cardiac care clinicians to promote oral health. METHOD: A needs assessment was undertaken with twelve patients with cardiovascular disease attending cardiac rehabilitation between 2015 and 2016, in three metropolitan hospitals in Sydney, Australia. These patients participated in face-to-face semi-structured interviews. Data was analysed using thematic analysis. RESULTS: Results suggested that while oral health was considered relevant there was high prevalence of poor oral health among participants, especially those from socioeconomic disadvantaged background. Awareness regarding the importance of oral health care its impact on cardiovascular outcomes was poor among participants. Oral health issues were rarely discussed in the cardiac setting. Main barriers deterring participants from seeking oral health care included lack of awareness, high cost of dental care and difficulties in accessing the public dental service. Findings also revealed that participants were interested in receiving further information about oral health and suggested various mediums for information delivery. The concept of cardiac care clinicians, especially nurses providing education, assessment and referrals to ongoing dental care was well received by participants who felt the post-acute period was the most appropriate time to receive oral health care advice. The issues of oral health training for non-dental clinicians and how to address existing barriers were highlighted by participants. RELEVANCE TO CLINICAL PRACTICE: The lack of oral health education being provided to patients with cardiovascular disease offers an opportunity to improve care and potentially, outcomes. In view of the evidence linking poor oral health with cardiovascular disease, cardiac care clinicians, especially nurses, should be appropriately trained to promote oral health in their practice. Affordable and accessible dental care services for people with cardiovascular disease should be considered and offered by health services in Australia.