Factors affecting access to oral healthcare for patients with cardiovascular disease in Australia

Introduction: Periodontal disease is a risk factor for atherosclerotic cardiovascular disease (CVD). Internationally, consensus statements recommend the inclusion of oral healthcare promotion in cardiac care settings. However, factors affecting access to oral healthcare of people with CVD are under-explored. Hypothesis: To identify factors associated with accessing oral healthcare among patients with CVD. Methods: A self-administered questionnaire was completed by patients attending outpatient cardiology services in Sydney Australia between December 2016 and March 2017. Data collected included socio-demographic information, last dental visit, oral health information received, oral health status, knowledge and barriers seeking dental care. Logistic regression analysis was used to determine predictors that influenced participants to visit a dentist in the last 12 months. Results: In total, 318 participants completed the study. Sixty percent were male and the mean age was 63.65 years (SD 14.52 years, range 18-94 years). Almost two-thirds of the participants had coronary artery disease (63.8%) with others (not mutually exclusive) suffering from arrhythmias, heart failure and valvular conditions. Dental problems were prevalent (77%) among participants yet only half saw a dentist in the last 12 months. The mean knowledge score was 52% and only 10% had received any oral health information. The main predictors for participants having seen a dentist in the previous 12 months were: i) receiving oral health information since cardiac diagnosis (Adjusted odds ratio [AOR] 5.97, 95% CI: 1.91 to 18.74); ii) having private health insurance (AOR: 3.25, 95% CI: 1.87 to 5.64); iii) being overseas-born (AOR: 2.16, 95% CI: 1.28 to 3.66); and iv) reporting low barriers to seeking dental healthcare (AOR: 1.91, 95% CI: 1.15 to 3.18). Conclusions: Dental problems are prevalent among people with CVD yet many have limited knowledge and information about the importance of oral health and only half are accessing dental care. Raising oral health awareness in the cardiac setting and providing access to affordable and accessible dental care could improve oral health status of people with CVD.