Emerging risk: Insufficient periodontal evaluation of known coronary heart disease patients

BACKGROUND: Comprehensive clinical and statistical research have established several major and contributing risk factors that increase the likelihood of developing heart disease, the leading cause of death in the United States. In light of current research on the association between periodontal disease and heart disease and given that both are indisputably widespread, understanding the significance and the benefits of interventions to prevent or control risk factors is of considerable public health value.

METHODS: During the summer of 2008, 122 physicians from Fayette County, Kentucky completed a cross-sectional survey (response rate 30%) concerning their pattern of case management for heart disease patients. The survey's 18 questions investigated assessment, referral, and treatment of known heart disease risk factors, including periodontal disease.

RESULTS: Initial results reveal that physicians who utilized their professional association to stay current with heart disease risk factor research (54.8%) were significantly more likely to provide an oral exam than physicians utilizing any other medium (p<.05). Residents/fellows (18.8%) and faculty (18.2%) were least likely to provide an oral exam compared to hospital based (26.7%) and private practice (44.3%) physicians (p<.05).

CONCLUSION: Preliminary findings indicate that physicians with heart disease patients do not provide oral exams and do not consider periodontal disease a risk factor. Results suggest that physicians would benefit from continuing education regarding the association between oral health and overall health. A dearth of research exists regarding the physician protocol for oral exam and dental referral, especially with a heart disease patient. Implications for future research will be discussed.