Periodontitis in patients with cirrhosis: a cross-sectional study

Lea Ladegaard Grønkjær, Palle Holmstrup, Søren Schou, Johanne Kongstad, Peter Jepsen, Hendrik Vilstrup, Lea Ladegaard Grønkjær, Palle Holmstrup, Søren Schou, Johanne Kongstad, Peter Jepsen, Hendrik Vilstrup

Abstract

Background: Many patients with cirrhosis have poor oral health but little is known on periodontitis, and its clinical significance is largely unknown. This study aimed to examine the prevalence and predictors of periodontitis, and evaluate the association of periodontitis with nutritional and systemic inflammation status.

Methods: 145 patients with cirrhosis were consecutively enrolled. Clinical, oral examination of plaque, pocket depth, clinical attachment level, and bleeding on probing was performed. Patients were categorized as having no-or-mild, moderate, or severe periodontitis. Predictors of severe periodontitis and the association with nutritional and systemic inflammation status were analyzed using univariable and multivariable logistic regression analyses.

Results: The large majority of patients had periodontitis, 46% of them severely and 39% moderately. Predictors of severe periodontitis included smoking (odds ratio (OR) 2.93, 95% confidence interval (CI) 1.29-6.63), brushing teeth twice daily (OR 0.30, 95% CI 0.11-0.79), and visiting the dentist annually (OR 3.51, 95% CI 1.22-10.81). Cirrhosis etiology or severity was not predictors of severe periodontitis. The patients with severe periodontitis had a higher nutritional risk score than patients with moderate, mild, or no periodontitis (3, interquartile range (IQR) 3-5 vs. 3, IQR 2-4, P = 0.02).

Conclusions: Most cirrhosis patients had significant periodontitis, the severity of which was related to life style factors and was associated with higher nutrition risk score. Our results emphasize the need for further research to establish the effect of periodontitis on cirrhosis.

Keywords: Cirrhosis; Inflammation status; Nutritional status; Oral health; Periodontitis.

Conflict of interest statement

Ethics approval and consent to participate

The study was fully approved by The Central Denmark Region Committees on Health Research Ethics (No. 1–10–72-128-12), and the study was conducted in accordance with the Declaration of Helsinki. All participating patients were given oral and written information regarding the aims of the study and its voluntary nature prior to the examination.

Consent for publication

The photograph shown in Fig. 2 was published with written consent.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Patient inclusion flowchart
Fig. 2
Fig. 2
Severe periodontitis in a patient

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