Periodontal disease and quality of life in patients with circulatory diseases

TAQUES, Luana; LÓPEZ, Lourdes Zeballos; TAQUES NETO, Lauro; ARCARO, Guilherme; MULLER, Erildo Vicente; SANTOS, Fabio André dos; POCHAPSKI, Marcia Thaís

doi:10.1590/1807-2577.00423

Brasil

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Original Article • Rev. Odontol. UNESP 52 • 2023 • https://doi.org/10.1590/1807-2577.00423 linkcopy

Periodontal disease and quality of life in patients with circulatory diseases

Doença periodontal e qualidade de vida em pacientes com doenças circulatórias

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction Circulatory system diseases are one of the leading causes of death. Periodontal health is a component of oral and general health that contributes to quality of life.

Objective To analyze periodontal conditions and quality of life in patients with circulatory diseases.

Material and method Cross-sectional study, with patients with circulatory diseases (n=125). The clinical periodontal examination was performed considering: biofilm, bleeding on probing, suppuration, probing depth, gingival recession, and clinical attachment level. Quality of life was assessed with the Medical Outcomes Study 36 – Item Short-Form Health Survey (SF-36) and Oral Health Impact Profile – short form (OHIP-14). Data were analyzed with parametric and nonparametric tests (α=5%).

Result Elderly and men had a greater severity of periodontal disease. The Elderly had lower values in the domains of "Functional capacity" and "Physical aspects" (SF-36). The domain "Pain" had lower values in subjects with health/gingivitis. OHIP-14 did not show differences in the comparisons. There was no correlation between quality of life and the severity of periodontal disease.

Conclusion Among patients with circulatory diseases, the elderly and men had greater severity of periodontal disease. The elderly had a poorer quality of life (functional capacity and physical aspects). There was no correlation between the severity of periodontal disease and quality of life.

Descriptors: Cardiovascular system; cardiovascular disease; oral health; periodontal diseases; quality of life

Variables	Values n = 125 (100%)
Age in years (mean ± standard deviation)	51.6 ± 13.1
<60 years	87 (70%)
≥60 years	38 (30%)
Gender
Female	76 (61%)
male	49 (39%)
Marital status
Single/ divorced/ widowed	42 (34%)
Stable union/married	83 (66%)
Monthly family income
≤3 minimum wages	114 (91%)
>3 minimum wages	11 (9%)
Educational Level
Illiterate	3 (2%)
Elementary	72 (58%)
High school	44 (35%)
Higher education	6 (5%)
Body max index (mean ± standard deviation)	29.7± 6.1
Slim/ normal	24 (19%)
Overweight	44 (35%)
Obesity	57 (46%)
Diagnosis - (ICD-10). Diseases of the circulatory system
(I06). Rheumatic aortic valve diseases	1 (1%)
(I10). Essential (primary) hypertension	23 (18%)
(I20). Angina pectoris	6 (5%)
(I24). Other acute ischemic heart diseases	4 (3%)
(I25). Chronic ischemic heart disease	1 (1%)
(I42). Cardiomyopathies	8 (6%)
(I47). Paroxysmal tachycardia	2 (2%)
(I48). Atrial flutter and fibrillation	1 (1%)
(I49). Other cardiac arrhythmias	4 (3%)
(I50). Heart failure	5 (4%)
(I65). Occlusion and stenosis of precerebral arteries, not resulting in cerebral infarction	1 (1%)
(I70). Atherosclerosis	3 (2%)
(I71). Aortic aneurysm and dissection	1 (1%)
(I72). Other aneurysm and dissection	1 (1%)
(I74). Arterial embolism and thrombosis	2 (2%)
(I82). Other venous embolism and thrombosis	4 (3%)
(I83). Varicose veins of lower extremities	54 (43%)
(I87). Other disorders of veins	4 (3%)
Medication use
None	29 (23%)
1 to 3	46 (37%)
>3	50 (40%)
Smoker
No	84 (67%)
Yes	11 (9%)
Former smoker	30 (24%)
Alcohol consumption
No	119 (95%)
Yes	1 (1%)
Former alcoholic	5 (4%)

Periodontal parameters	Total	Age		p-value	Gender		p-value	Severity of PD			p-value
Periodontal parameters	n=125 (100%)	<60 years n=87 (70%)	≥60 years n=38 (30%)	p-value	Fem n=76 (61%)	Male n=49 (39%)	p-value	Score 1 n=11 (9%)	Score 2 n=63 (50%)	Score 3 n=51 (41%)	p-value
Missing teeth (%)	33±27	28±27	45±24	<0.001*	33±28	32±26	0.863	52±27	28±27	35±25	0.038^†
Mean ± SD	9.2±7.5	7.8±7.4	12.6±6.7	- - -	9.3±7.8	9.1±7.2	- - -	14.5±7.6^a	7.9±7.5^b	9.8±7.1^ab	- - -
Biofilm (%)	68±26	67±24	71±29	0.332	67±25	70±26	0.467	64±28	63±26	75±24	0.065
Bleeding on probing (%)	48±24	51±21	39±27	0.007*	51±23	42±24	0.034*	42±21	47±22	50±26	0.474
Suppuration (%)	5±13	3±9	7±18	0.095	5±14	4±11	0.910	0.1±0.4^a	2±9^a	8±16^b	<0.001†
Probing depth (%)
1-3mm	86±16	86±17	87±15	0.699	88±13	83±20	0.149	99±1^a	92±9^b	76±20^c	<0.001^††
4-5mm	12±14	13±14	12±13	0.692	11±12	14±16	0.191	0.5±1^a	8±8^b	20±16^c	<0.001^††
≥6mm	2±14	2±5	1±2	0.837	1±2	2±6	0.189	0±0^a	0.2±0.6^a	3±6^b	<0.001^††
Gingival recession (%)
0mm	82±23	88±19	67±25	<0.001*	85±22	77±23	0.039*	96±9^a	90±16^a	69±26^b	<0.001^††
1-3mm	13±15	9±13	21±16	<0.001*	11±15	16±14	0.093	4±9^a	9±13^a	19±15^b	<0.001^††
≥4mm	5±11	3±8	10±16	0.002*	3±10	7±13	0.054	0±0^a	1±3^a	11±15^b	<0.001^††
Clinical attachment level (%)
0mm	71±25	75±23	61±25	0.003*	75±24	64±25	0.017*	95±8^a	82±16^b	52±22^c	<0.001^††
1-2mm	10±12	11±13	8±8	0.099	10±11	11±13	0.538	0.8±2^a	8±8^b	15±15^c	<0.001^††
3-4 mm	7±7	5±6	10±7	<0.001*	6±6	8±8	0.100	3±6^a	5±6^a	9±7^b	<0.001^††
≥5mm	12±19	9±16	22±23	<0.001*	10±18	17±21	0.042*	1±3^a	5±11^a	24±23^b	<0.001††
Severity of PD (scores)
Mean ± SD	2.3±0.6	2.2±0.6	2.5±0.6	0.030**	2.2±0.6	2.5±0.5	0.006**	- - -	- - -	- - -	- - -
Median (IQR)	2 (1–3)	2 (1–3)	3 (1–3)	- - -	2 (1–3)	3 (1–3)	- - -	- - -	- - -	- - -	- - -

Quality of life	Total	Age		p-value	Gender		p-value	Severity of PD			p-value
Quality of life	n=125 (100%)	<60 years n=87 (70%)	≥60 years n=38 (30%)	p-value	Fem n=76 (61%)	Male n=49 (39%)	p-value	Score 1 n=11 (9%)	Score 2 n=63 (50%)	Score 3 n=51 (41%)	p-value
SF-36
Functional capacity	54.4±34.7	59.9±34.7	41.6±31.5	0.006*	53.6±34.5	55.5±35.5	0.768	48.2±34.9	57.5±33.0	51.8±37.0	0.571
Physical aspects	40.8±44.6	47.4±44.6	25.7±41.3	0.012*	42.4±44.7	38.2±44.8	0.612	27.3±42.5	48.0±44.7	34.8±44.2	0.183
Pain	55.4±27.8	57.4±26.4	50.8±30.6	0.222	52.7±29.1	59.6±25.3	0.175	34.0±16.1^a	58.5±27.3^b	56.1±28.7^b	<0.001†
General health status	61.1±24.6	59.4±24.2	65.0±25.1	0.239	62.7±24.5	58.6±24.7	0.367	58.0±26.5	61.8±23.5	60.8±25.9	0.903
Vitality	52.6±25.8	53.4±26.6	50.5±24.1	0.563	52.6±27.4	52.6±23.2	0.998	40.9±30.6	54.4±25.3	52.8±25.2	0.409
Social aspects	70.1±30.2	69.1±31.3	72.4±28.1	0.581	68.8±31.3	72.2±28.7	0.536	68.2±30.3	70.0±30.6	70.6±30.4	0.972
Emotional aspects	50.4±47.1	55.2±47.4	39.5±45.1	0.086	51.8±47.3	48.3±47.2	0.690	42.4±42.4	52.9±48.1	49.0±47.3	0.747
Mental health	61.0±23.3	61.0±23.6	61.1±23.0	0.993	59.7±24.7	63.0±21.1	0.445	52.4±21.6	61.6±23.4	62.2±23.7	0.403
Total SF-36	55.3±23.1	57.9±24.3	49.4±19.0	0.059	54.8±23.8	56.0±22.1	0.780	46.4±22.6	58.1±22.9	53.7±23.3	0.262
OHIP-14
Functional limitation	0.64±0.90	0.55±0.83	0.84±1.01	0.090	0.68±0.90	0.57±0.90	0.521	1.00±0.84	0.54±0.83	0.68±0.98	0.247
Physical pain	1.30±1.03	1.28±1.01	1.36±1.10	0.695	1.34±1.05	1.25±1.01	0.634	1.73±0.82	1.25±1.08	1.27±1.01	0.233
Psychological discomfort	1.66±1.33	1.72±1.36	1.51±1.24	0.429	1.78±1.40	1.45±1.21	0.208	2.32±1.49	1.58±1.08	1.61±1.08	0.318
Physical disability	0.96±1.13	1.01±1.23	0.87±0.90	0.536	1.10±1.19	0.75±1.02	0.083	1.73±1.45	0.86±1.08	0.92±1.08	0.211
Psychological disability	1.19±1.13	1.20±1.17	1.17±1.03	0.892	1.31±1.16	1.00±1.06	0.127	1.73±1.56	1.05±1.11	1.26±1.02	0.308
Social disability	0.71±1.05	0.67±1.01	0.82±0.98	0.466	0.76±1.15	0.63±0.87	0.499	1.09±1.45	0.63±1.03	0.73±0.97	0.568
Handicapped	0.68±1.07	0.69±1.13	0.67±0.92	0.929	0.80±1.19	0.50±0.82	0.123	1.14±1.47	0.49±0.99	0.82±1.04	0.147
OHIP- Total	7.14±5.91	7.10±6.20	7.24±5.35	0.908	7.78±6.13	6.16±5.45	0.137	10.7±7.84	6.40±5.67	7.30±5.54	0.218

Domains of SF-36	Severity of Periodontal Disease
Domains of SF-36	rs	p-value
Functional capacity	-0.047	0.605
Physical aspects	-0.072	0.422
Pain	0.094	0.299
General health status	0.016	0.864
Vitality	0.041	0.651
Social aspects	0.020	0.829
Emotional aspects	-0.014	0.876
Mental health	0.084	0.349
Total SF-36	-0.015	0.872
Domains of OHIP-14
Functional limitation	-0.049	0.584
Physical pain	-0.069	0.441
Psychological discomfort	-0.066	0.466
Physical disability	-0.076	0.411
Psychological disability	0.026	0.778
Social disability	0.024	0.791
Handicapped	0.127	0.158
OHIP- Total	-0.001	0.999

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[1] (*) Significant differences; Student’s t-test for independent samples, p≤0.05. (**) Significant differences; Mann-Whitney test, p≤0.05. Severity of periodontal disease; (†) Significant differences; ANOVA with Tukey’s post-hoc test. (††) Significant differences; Kruskal-Wallis with Dwass-Steel-Critcholw-Fligner post-hoc test; (different letters indicate significant differences, p≤0.05). PD. Periodontal disease; Score 1 (Health/Gingivitis); Score 2 (Periodontitis Stages 1 and 2); Score 3 (Periodontitis Stages 3 and 4). SD. Standard deviation. IQR. Interquartile range.