Despite poor oral hygiene, cystic fibrosis patients may exhibit lower levels of clinical gingivitis and periodontitis: Study

A study was done to investigate the prevalence of gingivitis and periodontitis, and the oral hygiene status of adults with cystic fibrosis (CF) in the Republic of Ireland. A case–control study in the form of a clinical examination of 92 adults with a diagnosis of CF was carried out in the adult CF unit in Cork University Hospital. A 40-item questionnaire was used to capture socio-demographic variables and medical and dental information. Two calibrated examiners carried out a periodontal assessment on participants, using the WHO-recommended CPI-modified index, and oral hygiene status was measured using the Greene–Vermillion index. The results were compared with a population-based control group of similar socio-demographic profile. Results: Oral hygiene levels (plaque and calculus) were significantly worse in people with CF, with a median plaque index of 0.83 (interquartile range [IQR] 0.333–1.542) in the CF group compared with 0.5 (IQR 0.167–0.667) in the non-CF group. Calculus index in the CF group was 0.33 (IQR 0.17–0.83) compared with 0.33 (IQR 0.125–0.33) in the non-CF group. However, periodontal disease levels were significantly lower in the CF group. Gingivitis (bleeding on probing ≥ 10% sites) was seen in 67.4% of the CF group, compared with 83.7% of the non-CF group, OR 0.365 (95% confidence interval [CI] 0.181–0.736), relative risk (RR) 0.779 (95% CI 0.655–0.928). Mild periodontitis (periodontal probing depth [PPD] < 5 mm) was seen in 15.2% of the CF group, compared with 31.5% of the non-CF group, OR 0.390 (CI 0.190–0.800), RR 0.483 (95% CI 0.273–0.852).

Severe periodontitis (PPD ≥ 6 mm) was seen in 0% of the CF group, compared with 9.8% of the non-CF group. There was a tendency, albeit non-significant, towards reduced periodontitis in PWCF who regularly took antibiotics, particularly azithromycin. In this study, adults with CF had poor oral hygiene practices, with high levels of plaque and calculus. Despite this finding, adults with CF had lower levels of clinical gingivitis and periodontitis than seen in a non-CF control group. Further study is required to examine the causes of this phenomenon. There is a lack of studies on the periodontal status of people with cystic fibrosis (PWCF), due to their historically low life expectancy. Knowledge regarding the periodontal status of these individuals is pertinent as they may require dental evaluation prior to solid organ transplantation, and periodontal disease can impact respiratory function, which is already compromised by cystic fibrosis (CF). This study investigated the oral hygiene and prevalence of gingivitis and periodontitis in adults with CF. Principal findings: There were relatively high levels of plaque and calculus in PWCF studied. Despite this, they had lower levels of clinical gingivitis and periodontitis. 

Reference:

Coffey, N., O'Leary, F., Burke, F., Kirwan, L., O'Regan, P., Plant, B., Roberts, A., & Hayes, M. (2024). Periodontal disease prevalence and oral hygiene status of adults with cystic fibrosis: A case–control study. Journal of Clinical Periodontology, 1–12. https://doi.org/10.1111/jcpe.13944

Keywords:

poor oral hygiene, cystic fibrosis patients, lower levels, clinical gingivitis, periodontitis, Journal Of Clinical Periodontology, Coffey, N., O'Leary, F., Burke, F., Kirwan, L., O'Regan, P., Plant, B., Roberts, A., & Hayes, M