Periodontitis as Risk Factor for Acute Myocardial Infarction: A Case Control Study Authors: Sujai M. Parker, Gunjan N. Jodi, Jalak Jani Department of Public Health Dentistry, Ahmedabad Dental College and Hospital, Gujarat, India & Department of oral hygiene and radiology, Ahmedabad Dental College and Hospital, Gujarat, India Presented by: LaWanda Young

Introduction Cardiovascular disease (CVD) has been a well known issue concerning global health for sometime. It is the leading cause of death worldwide and more prevalent among men. There are many risk factors association with CVD such as unhealthy diet, physical inactivity, tobacco use, and alcohol (WHO 2014). Periodontitis disease is also a well known disease that has its affects. The risk factors for periodontitis disease is smoking, use of certain medications, genetic susceptibility, and diabetes and other illnesses (NIH n.d.). Is periodontitis a risk factor for acute myocardial infarction? Is there an association between periodontal and AMI? To answer these questions a research study was conducted. This studies objective is to assess the periodontal status among the patients suffering form acute myocardial infraction an to determine if periodontitis is a risk factor (Parker, Modi, & Jani 2013).

Methods Study design: Case-Control Study The study is a secondary study, from a previous cross- sectional study that required more information regarding the association between periodontitis and AMI. Researchers obtain data by qualitative and quantitative nature. Personal Interviews- gathered information about adverse habits and past history Patients Files- retrieved medical data Clinical Oral Examinations- identified the physical state of the mouth of each patient. Definitions Case control study- compare exposure histories in people with (cases) and without (control) the disease (Jacobsen 2012). Acute Myocardial Infarction (AMI)- heart attack Oral Hygiene- the practice of keeping the mouth healthy. Periodontitis disease- inflammation and infection of the ligaments and bones that support teeth. Risk factor- a variable that is associated with the increases of disease.

Methods Informed consent was giving by all participants. Approved by the ethical committee of Ahmedabad Dental College and Hospital, Gujarat, India The clinical examinations were conducted by the V.S. General Hospital, Ahmedabad by two trained dentists To examine the patients artificial light and a plan mouth mirror was used

Results Research population comprised of 60 subjects. 21 males and 9 females; 70/30. 30 with AMI (cases) 30 healthy patients (controls) Ages range from 54.3 +-11.0 years and 53.07 +- 10.53 years for both groups, cases and controls. Groups matched by age and gender and control group consisted of relatives to the patients with AMI

Results Oral hygiene status (OHI-S) for the groups were highly significant statistically because the difference in score pertaining to the amount of unhealthiness. The case group had a higher oral hygiene score which indicated poorer hygiene. Periodontitis status (CPI and LOA) of the mean score compared for both groups were had statistically highly significant in some areas and no significant in others, shown in table 1. The clinical exam and risk factors of age, gender, smoking, and alcohol was no significant shown in table 2. The oral hygiene and periodontitis status got worse the higher the age. Males more prone to periodontitis than women.

Results Parker, Modi, Jani 2013 Table 2: Association between oral and known risk factors for AMI Table 1: Comparison of clinical parameter between case and control Parker, Modi, Jani 2013

Conclusion The results of the study indicate that there is an association with between periodontitis disease and AMI. There were two conclusion drawn from the study that indicated the results to be supported. The worsening of periodontitis disease in patients with AMI and the differences shown regarding cut off values of oral hygiene in healthy patients.

Future Research Future research regarding periodontist as a risk factor for AMI is indicated. There was limits to the study the prohibited thorough research to the study. Such as: The small sample size Contained population The use of one hospital The use of clinic exams to identify periodontitis disease. According to Parker, Modi, and Jani, the study showed strong association between periodontitis and AMI but to break potentially confounded association larger and better controlled studies involving social homogenous population are required (2013).

References Jacobsen, K. H. (2012). Introduction to health research methods: A practical guide. Sudbury, MA: Jones & Bartlett Learning Parker, S. M., Modi, G.N., & Jani, J. (2013). Periodontitis as risk factor for acute myocardial infarction: A case control study. Heart Views, 14 (1), 5-11. http://dx.doi.org/10.4103/1995-705x.107113 Periodontitis disease2014. In Merriam-Webster.com. Retrieved November 30, 2014, from http://www.merriam-webster.com/dictionary/periodontitisdisease World Health Organization. (2014). Cardiovascular disease. Retrieved from http://www.who.int/mediacentre/factsheets/fs317/en/ National Institute of Dental and Craniofacial Research. (n.d.) Periodontal (gum) disease: Causes, Symptoms, and treatments. Retrieved from http://www.nidcr.nih.gov/oralhealth/topics/gumdiseases/periodontalgumdisease.htm#intro