Abstract
Patients with hyperlipidaemia are important because of the possible interplay between oral infectious lesions, odontogenic infection-related systemic microinflammation and hyperlipidaemia resulting in an elevated risk for cardiovascular disease (CVD).
Aim: The aim of this study was to evaluate changes in the serum C-Reactive Protein (CRP) levels and lipid parameters of patients with hyperlipidaemia in parallel with the improvements in oral health due to comprehensive dental treatment.
Methods: All forty four patients (age range 32 to 71) who attended the Internal Medicine Department of the Medical and Science Centre, University of Debrecen (MHSC UD), between March 2005 and April 2007 and who met the inclusion criteria were invited to take part in the study. Of these, twentyeight patients with Fredrickson type IIa and IIb hyperlipidaemia, receiving lipid lowering therapy for at least 6 months, who consented to take part, underwent comprehensive dental and laboratory examinations. Serum hsCRP, lipid and lipoprotein concentrations were determined and sub- and supragingival microflora were characterised. Patients received comprehensive dental treatment at the beginning of the study. Oral health parameters and microflora were checked 3-months after completing dental treatment. Serum high sensitivity CRP (hsCRP) and lipid parameters were re-assessed 1-week and 3-months after treatment. Normal distribution was assessed by the Kolmogorov-Smirnov test. Changes in the variables during follow-up were evaluated by one-way ANOVA and mean values were compared by paired t-test. If parametric approaches could not be applied, the Friedman test, Wilcoxon test and/or Mann-Whitney test were used. To evaluate the effects of confounding variables stepwise linear regression analysis was applied. Ethics approval was given by the ethics committee of the MHSC UD.
Results: No clinically relevant changes were observed at 1-week follow-up. At 3-months, periodontal indicators , including plaque indices, gingival indices and periodontal probing depths, improved significantly. There was a significant shift from a predominantly Gram-negative microflora detected on admission to a Gram-positive microflora following therapy, accompanied by a significant reduction in serum hsCRP and total cholesterol concentrations. Male patients and patients receiving non-surgical dental treatments experienced a significant high density lipoprotein C (HDL-C) increase.
Conclusions: Results of this study suggest that, in the group studied, improvements in oral health by comprehensive dental treatment were associated with decreases in serum hsCRP and improvements in lipid profile, exposing patients with hyperlipidaemia to a decreased CVD risk, representing an effective adjunct to lipid lowering therapy and preventive cardiology and hence an effective public health intervention.
Get full access to this article
View all access options for this article.