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Evaluation of risk factors for oral infection with potential for spread in a 1-year cohort study

  • Esa Färkkilä
  • Riina Rautemaa-Richardson
  • Anniina Färkkilä
  • Lotta Grönholm
  • Anneli Lauhio
Original Article

Abstract

Objectives

To determine the frequency of oral infection with potential for spread (OIPS) and behavioural risk factors in patients referred to a regional tertiary care-centre for OIPS assessment and clearance.

Materials and methods

A database search of all referrals to the Oral and Maxillofacial Diseases unit of HUH in 2009 was performed. Of the 2807 referrals, 408 were due to a known or suspected OIPS. The electronic patient records of these patients were analysed for patient demographics, lifestyle factors, radiological findings and clinical oral findings. Risk factors for OIPS were analysed using logistic regression and using the significant factors in univariate analyses in the multivariate models.

Results

The mean age of the patients was 58 years. Most patients (n = 270, 66%) were referred due to upcoming cancer or other immunosuppressive therapy. The majority (n = 314, 77%) were diagnosed with one or more OIPS. In univariate analyses, smoking (OR 3.2, 95% CI 1.6–6.4; p = 0.0006), male gender (OR 1.7, 95% CI 1.1–2.8; p = 0.02), excessive alcohol use (OR 3.0, 95% 1.1–7.9; p = 0.03) and irregular dental care (OR 4.8, 95% CI 2.6–8.8; p < 0.0001) were risk factors for OIPS. However, in multivariate analyses, smoking was the only independent risk factor for OIPS (OR 3.6, 95% CI 1.2–11.8; p = 0.02).

Conclusions

OIPS are common in patients referred for OIPS clearance, and smoking was identified as an independent behavioural risk factor for them. These findings highlight the burden of disease in this patient group and the importance of smoking cessation encouragement.

Clinical relevance

To identify patients at increased risk of OIPS.

Keywords

Alcohol Dental clearance Oral diseases Oral infections Smoking 

Notes

Acknowledgements

We thank MSc PhD Emmi Tikkanen for statistical advice.

Funding

This article presents independent research supported by grant from Helsinki University Central Hospital, HUS EVO TYH 2014 223. The funder had no role in the design, conduct or data interpretation or writing of this study, but the authors carried out this research independently of the funding bodies.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.

References

  1. 1.
    Wilmoth JR (2000) Demography of longevity: past, present, and future trends. Exp Gerontol 35:1111–1129CrossRefPubMedGoogle Scholar
  2. 2.
    Mattila KJ, Nieminen MS, Valtonen VV, Rasi VP, Kesaniemi YA, Syrjala SL et al (1989) Association between dental health and acute myocardial infarction. BMJ 25:779–781CrossRefGoogle Scholar
  3. 3.
    Buhlin K, Mantyla P, Paju S, Peltola JS, Nieminen MS, Sinisalo J et al (2011) Periodontitis is associated with angiographically verified coronary artery disease. J Clin Periodontol 38:1007–1014CrossRefPubMedGoogle Scholar
  4. 4.
    Rautemaa R, Lauhio A, Cullinan MP, Seymour GJ (2007) Oral infections and systemic disease—an emerging problem in medicine. Clin Microbiol Infect 13:1041–1047CrossRefPubMedGoogle Scholar
  5. 5.
    Carramolino-Cuellar E, Tomas I, Jimenez-Soriano Y (2014) Relationship between the oral cavity and cardiovascular diseases and metabolic syndrome. Med Oral Patol Oral Cir Bucal 19:e289–e294CrossRefPubMedGoogle Scholar
  6. 6.
    Lahti S, Suominen-Taipale L, Hausen H (2008) Oral health impacts among adults in Finland: competing effects of age, number of teeth, and removable dentures. Eur J Oral Sci 116:260–266CrossRefPubMedGoogle Scholar
  7. 7.
    Seppanen L, Lauhio A, Lindqvist C, Suuronen R, Rautemaa R (2008) Analysis of systemic and local odontogenic infection complications requiring hospital care. J Inf Secur 57:116–122Google Scholar
  8. 8.
    Robertson DP, Keys W, Rautemaa-Richardson R, Burns R, Smith AJ (2015) Management of severe acute dental infections. BMJ 350:h1300CrossRefPubMedGoogle Scholar
  9. 9.
    Cotti E, Dessi C, Piras A, Flore G, Deidda M, Madeddu C et al (2011) Association of endodontic infection with detection of an initial lesion to the cardiovascular system. J Endod 37:1624–1629CrossRefPubMedGoogle Scholar
  10. 10.
    Helenius-Hietala J, Meurman JH, Hockerstedt K, Lindqvist C, Isoniemi H (2012 Feb) Effect of the aetiology and severity of liver disease on oral health and dental treatment prior to transplantation. Transpl Int 25:158–165CrossRefPubMedGoogle Scholar
  11. 11.
    Yamagata K, Onizawa K, Yanagawa T, Hasegawa Y, Kojima H, Nagasawa T, Yoshida H (2006) A prospective study to evaluate a new dental management protocol before hematopoietic stem cell transplantation. Bone Marrow Transplant 38:237–242CrossRefPubMedGoogle Scholar
  12. 12.
    Schuurhuis JM, Stokman MA, Roodenburg JL, Reintsema H, Langendijk JA, Vissink A et al (2011) Efficacy of routine pre-radiation dental screening and dental follow-up in head and neck oncology patients on intermediate and late radiation effects. A retrospective evaluation. Radiother Oncol 101:403–409CrossRefPubMedGoogle Scholar
  13. 13.
    Bergmann OJ (1988) Oral infections and septicemia in immunocompromised patients with hematologic malignancies. J Clin Microbiol 26:2105–2109PubMedPubMedCentralGoogle Scholar
  14. 14.
    Laine PO, Lindqvist JC, Pyrhonen SO, Strand-Pettinen IM, Teerenhovi LM, Meurman JH (1992) Oral infection as a reason for febrile episodes in lymphoma patients receiving cytostatic drugs. Eur J Cancer B Oral Oncol 28B:103–107CrossRefPubMedGoogle Scholar
  15. 15.
    Grbic JT, Lamster IB (1992) Risk indicators for future clinical attachment loss in adult periodontitis. Tooth and site variables. J Periodontol 63:262–269CrossRefPubMedGoogle Scholar
  16. 16.
    Taylor GW (2001) Bidirectional interrelationships between diabetes and periodontal diseases: an epidemiologic perspective. Ann Periodontol 6:99–112CrossRefPubMedGoogle Scholar
  17. 17.
    Kocher T, Schwahn C, Gesch D, Bernhardt O, John U, Meisel P, Baelum V (2005) Risk determinants of periodontal disease—an analysis of the study of health in Pomerania (SHIP 0). J Clin Periodontol 32:59–67CrossRefPubMedGoogle Scholar
  18. 18.
    Bergstrom J (2006) Periodontitis and smoking: an evidence-based appraisal. J Evid Based Dent Pract 6:33–41CrossRefPubMedGoogle Scholar
  19. 19.
    Axelsson P, Lindhe J (1981) Effect of controlled oral hygiene procedures on caries and periodontal disease in adults. Results after 6 years. J Clin Periodontol 8:239–248CrossRefPubMedGoogle Scholar
  20. 20.
    Jette AM, Feldman HA, Tennstedt SL (1993) Tobacco use: a modifiable risk factor for dental disease among the elderly. Am J Public Health 83:1271–1276CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Bruno-Ambrosius K, Swanholm G, Twetman S (2005) Eating habits, smoking and toothbrushing in relation to dental caries: a 3-year study in Swedish female teenagers. Int J Paediatr Dent 15:190–196CrossRefPubMedGoogle Scholar
  22. 22.
    Jansson L (2008) Association between alcohol consumption and dental health. J Clin Periodontol 35:379–384CrossRefPubMedGoogle Scholar
  23. 23.
    Holmen A, Stromberg U, Magnusson K, Twetman S (2013) Tobacco use and caries risk among adolescents—a longitudinal study in Sweden. BMC Oral Health 13:31CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Kirkevang LL, Wenzel A (2003) Risk indicators for apical periodontitis. Community Dent Oral Epidemiol 31:59–67CrossRefPubMedGoogle Scholar
  25. 25.
    Jansson L (2008) Association between alcohol consumption and dental health. J Clin Periodontol 35:379–384CrossRefPubMedGoogle Scholar
  26. 26.
    Chala S, Abouqal R, Abdallaoui F (2011) Prevalence of apical periodontitis and factors associated with the periradicular status. Acta Odontol Scand 69:355–359CrossRefPubMedGoogle Scholar
  27. 27.
    Haber J, Wattles J, Crowley M, Mandell R, Joshipura K, Kent RL (1993) Evidence for cigarette smoking as a major risk factor for periodontitis. J Periodontol 64:16–23CrossRefPubMedGoogle Scholar
  28. 28.
    Hugoson A, Hellqvist L, Rolandsson M, Birkhed D (2012) Dental caries in relation to smoking and the use of Swedish snus: epidemiological studies covering 20 years (1983-2003). Acta Odontol Scand 70:289–296CrossRefPubMedGoogle Scholar
  29. 29.
    Benedetti G, Campus G, Strohmenger L, Lingstrom P (2013) Tobacco and dental caries: a systematic review. Acta Odontol Scand 71:363–371CrossRefPubMedGoogle Scholar
  30. 30.
  31. 31.
    Arno A, Waergehaug J, Lovdal A, Schei O (1958) Incidence of gingivitis as related to sex, occupation, tobacco consumption, toothbrushing, and age. Oral Surg Oral Med Oral Pathol 11:587–595CrossRefPubMedGoogle Scholar
  32. 32.
    Summers CJ, Oberman A (1968) Association of oral disease with 12 selected variables. I. Periodontal disease. J Dent Res 47:457–462CrossRefPubMedGoogle Scholar
  33. 33.
    Radvar M, Darby I, Polster A, Arashi M, Moeintaghavi A, Sohrabi K (2011) Pattern of cigarette smoking effect on periodontal pocketing and attachment loss: a retrospective study. Int J Dent Hyg 9:291–295CrossRefPubMedGoogle Scholar
  34. 34.
    Kirkevang LL, Vaeth M, Horsted-Bindslev P, Bahrami G, Wenzel A (2007) Risk factors for developing apical periodontitis in a general population. Int Endod J 40:290–299CrossRefPubMedGoogle Scholar
  35. 35.
    Bergstrom J, Babcan J, Eliasson S (2004) Tobacco smoking and dental periapical condition. Eur J Oral Sci 112:115–120CrossRefPubMedGoogle Scholar
  36. 36.
    Axell T, Pindborg JJ, Smith CJ, van der Waal I (1996) Oral white lesions with special reference to precancerous and tobacco-related lesions: conclusions of an international symposium held in Uppsala, Sweden, May 18-21 1994. International collaborative group on oral white lesions. J Oral Pathol Med 25:49–54CrossRefPubMedGoogle Scholar
  37. 37.
    Lewin F, Norell SE, Johansson H, Gustavsson P, Wennerberg J, Biorklund A et al (1998) Smoking tobacco, oral snuff, and alcohol in the etiology of squamous cell carcinoma of the head and neck: a population-based case-referent study in Sweden. Cancer 82:1367–1375CrossRefPubMedGoogle Scholar
  38. 38.
    Calsina G, Ramon JM, Echeverria JJ (2002) Effects of smoking on periodontal tissues. J Clin Periodontol 29:771–776CrossRefPubMedGoogle Scholar
  39. 39.
    Tonetti MS, Eickholz P, Loos BG, Papapanou P, van der Velden U, Armitage G, Bouchard P, Deinzer R, Dietrich T, Hughes F, Kocher T, Lang NP, Lopez R, Needleman I, Newton T, Nibali L, Pretzl B, Ramseier C, Sanz-Sanchez I, Schlagenhauf U, Suvan JE (2015) Principles in prevention of periodontal diseases: consensus report of group 1 of the 11th European Workshop on Periodontology on effective prevention of periodontal and peri-implant diseases. J Clin Periodontol 42:S5–11Google Scholar
  40. 40.
    Ramseier CA, Suvan JE (2015) Behaviour change counselling for tobacco use cessation and promotion of healthy lifestyles: a systematic review. J Clin Periodontol 42:S47–S58CrossRefPubMedGoogle Scholar
  41. 41.
    Hand JS, Hunt RJ, Kohout FJ (1991) Five-year incidence of tooth loss in Iowans aged 65 and older. Community Dent Oral Epidemiol 19:48–51CrossRefPubMedGoogle Scholar
  42. 42.
    Weikert C, Dietrich T, Boeing H, Bergmann MM, Boutron-Ruault MC, Clavel-Chapelon F et al (2009) Lifetime and baseline alcohol intake and risk of cancer of the upper aero-digestive tract in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Int J Cancer 15:406–412CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Esa Färkkilä
    • 1
  • Riina Rautemaa-Richardson
    • 2
    • 3
  • Anniina Färkkilä
    • 4
  • Lotta Grönholm
    • 5
  • Anneli Lauhio
    • 6
  1. 1.Department of Oral and Maxillofacial SurgeryHelsinki University Hospital and University of HelsinkiHUS, HelsinkiFinland
  2. 2.Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
  3. 3.Department of Infectious Diseases, Wythenshawe HospitalManchester University NHS Foundation TrustManchesterUK
  4. 4.Department of Obstetrics and GynaecologyHelsinki University Hospital and University of HelsinkiHUS, HelsinkiFinland
  5. 5.Department of OncologyHelsinki University Hospital and University of HelsinkiHUS, HelsinkiFinland
  6. 6.Department of Infectious Diseases, Inflammation CenterHelsinki University Hospital and University of HelsinkiHUS, HelsinkiFinland

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