A Clinical Study:The Relationship Between Oral Hygiene And Carotid Plaque Thickness Of Middle-aged And Elderly Inpatients With Atherosclerotic Cardiovascular Disease

Objective:As for the middle-aged and elderly patients with atherosclerotic cardiovascular disease,thicker carotid plaques do harm to medical condition.The severity of oral infection is a specific risk factor for carotid atherosclerosis and plaque formation.On this basis,our study which classified these inpatients into different groups according to maximal plaque thickness aimed to discuss the possible relationship of these patients between oral hygiene（status and routine）and carotid plaque maximal thickness with the apply of carotid ultrasonography,questionnaire and oral examination.Methods:376 inpatients,who were in department of Cardiology of atherosclerotic cardiovascular disease hospital of Shanxi Province were involved in this research from May 2016 to November 2016.We carried out a questionnaire about patients’general information（personal details,life style and previous medical history）and oral hygiene routine（frequency of brushing,brushing time and bleeding when they were brushing）,an oral examination（the number of missing teeth,gingival index and calculus index）and a carotid ultrasonography for intima–media thickness of carotid artery and formation of plaque.According to inclusion criteria,212 patients were enrolled.In line with the maximal thickness of plaque,We divided patients into three-level groups which named:1^stlesion group（1.5～2.5mm）,2^ndlesion group（2.5～3.5mm）and 3^rdlesion group（≥3.5mm）.Results:1.In this research,the proportion of hypertension,coronary heart disease,hyperlipidemia and diabetes’s history were 60.4%,30.7%,29.2%,23.6%,as hypertension and coronary heart disease’s proportion were much higher than Chinese normal prevalence.2.There were 45（21%）,146（69%）,21（10%）patients in 1^stto 3^rdgroups respectively.3.Signal factor analysis of basic information:The age was statistically significant（P<0.05）,patients’plaque thickness levels of group 1～3 were increased with ages,and they respectively were 59.022±9.962 years,62.966±8.234 years,65.190±7.814years.While gender,BMI,smoking,hypertension,history of diabetes,history of coronary heart disease and history of hyperlipidemia had no statistical significance;3.Signal factor analysis of oral hygiene（status and routine）:the number of missing teeth,gingival index and frequency of brushing were statistically significant（P<0.05）,calculus index and brushing time had no statistical significance;4.Ordinal logistic regression analysis of four significant factors:number of missing teeth and gingival index were risky to plaque thickness levels:Compared with number of missing teeth less than 5,the risk increased to 3.687 fold（OR=3.687,95%CI:1.605～8.474,P=0.002）in number of missing teeth between 5～8.It was significant that if the number of missing teeth exceeded 9,the risk would increase to 3.687 times（OR=5.306,95%CI:2.270～12.404,P<0.001）.With the increase of gingival index,the risk increased by 1.5～2.5 fold（gingival index=1:OR=2.557,95%CI:1.073～6.098,P=0.034;=2:OR=3.462,95%CI:1.470～8.158,P=0.005）compared with non-inflammatory ones.While the frequency of brushing time might be a protective factor of plaque thickness levels（≥2 times/d VS<2times/d:OR=0.446,95%CI:0.233～0.852,P=0.015）.Conclusion:1.Eliminating some traditional risk factors,poor oral hygiene was a risk factor of elevated plaque thickness levels for middle-aged and elderly inpatients with atherosclerotic cardiovascular disease in our research:with the increase of number of missing teeth and gingival index,the grade of plaque thickness went up accordingly.However,the increase of the brushing frequency might be an efficient protective factor.2.These three indexes（number of missing teeth,gingival index and frequency of brushing）are accessible and oral examination could be an auxiliary way to estimate the state and prognosis of these patients.