Better outcomes for heart attack patients on perio care

USA: Researchers from the University of Michigan found that patients who had heart attacks and received periodontal maintenance care recorded the shortest hospitalization stays, and more follow-up visits.

The University team studied patients who were receiving periodontal care, dental cleanings or no dental care during 2016-2018 and who had acute myocardial infarction (heart attack) in 2017.

Periodontal care group stayed longest

They found the no-dental-care group had the longest length of stay at the hospital. This contrasted with the results of the other groups that received active periodontal care and regular care.

“After controlling for several factors, the periodontal care group had higher odds of having post-hospital visits,” said study co-author Romesh Nalliah, associate dean for patient services at the U-M School of Dentistry.

According to Nalliah, there are 800,000 myocardial infarctions in the United States yearly, and those with periodontal disease are at increased risk for hospitalization after a heart attack.

No causal relationship established

Although the study, published in the Journal of the American Dental Association, did not establish a causal relationship between periodontal disease and heart disease, he believes this type of research bolsters the understanding supporting an association between oral health and overall health.

The research examined 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 with profiles meeting their criteria. Among them, 47% percent had 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.

Communication helps

“Dentistry is often practiced in isolation from overall health care,” Nalliah said. “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, he added, could help with early intervention to ensure stable periodontal health in patients who have risk factors for heart disease.

“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,” he said.

Co-authors include Tanima Basu, senior statistician at the Michigan Hospital Medicine Safety Consortium, and Chiang-Hua Chang, research assistant professor at Michigan Medicine.