Periodontal status of the patients presenting with pulmonary disease in a tertiary health care facility in eastern Nepal.

Background: Periodontitis and pulmonary disease both are common diseases of humans worldwide and are interconnected to each other. Pulmonary disease is one of the leading causes of morbidity and mortality globally. Poor periodontal health has been attributed to enhance multiple systemic diseases including respiratory disease. Therefore, the study was carried out to determine the periodontal status of patients presenting with pulmonary disease and also to assess the association of periodontitis with pulmonary disease along with their oral health behavior.

Methods: A cross-sectional study was conducted among 103 patients (> 18 years) diagnosed primarily with pulmonary disease in pulmonology/internal medicine ward of a tertiary health care facility in eastern Nepal. A pretested structured questionnaire (WHO-2013 oral health questionnaire for adults/ Global adult tobacco survey questionnaire) was used to assess oral health behavior of participants. Plaque index, gingival index, pocket depth and attachment loss were recorded to assess periodontal condition. Chi square test, t-test and ANOVA were used based on nature of variables. The level of significance was set at p < 0.05.

Results: The mean age of participants was 63.57 (± 16.42) ranging from 19 - 89 years. Male participants were higher (60.2%) compared to female (39.8%). Most of the participants were former smokers (79.6%) and former smokeless tobacco users (62.1%). Majority of the participants had fair plaque control (75.6%) and moderate form of gingivitis (92.2%). Of the total (n = 103) participants, 36.9% (n = 38) were diagnosed with COPD, 23.3% (n = 24) with pneumonia, 18.4% (n = 19) with pulmonary tuberculosis and 21.4% (n = 22) with lung malignancy. Overall, 85.5% of participants had periodontitis. More than two-thirds (73.3%) had moderate periodontitis, followed by severe periodontitis (11.1%). Out of all forms of pulmonary disease periodontitis was found to be higher in COPD group (33.8%). No association was observed between periodontitis and pulmonary disease (p = 0.05) whereas former smokers, former smokeless tobacco users and gingival index score was found to be associated (p < 0.05).

Conclusion: More than two-third of the participants diagnosed primarily with pulmonary disease had periodontitis. No association was observed between periodontitis and pulmonary disease. However, gingival index score, habit of smoking and smokeless tobacco was associated with periodontitis.