Oral health access and self-reported outcomes in patients with chronic intestinal failure requiring home intravenous support.
chronic intestinal failure
dental health
home parenteral nutrition
oral health
Journal
Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition
ISSN: 1941-2452
Titre abrégé: Nutr Clin Pract
Pays: United States
ID NLM: 8606733
Informations de publication
Date de publication:
05 Aug 2024
05 Aug 2024
Historique:
revised:
26
06
2024
received:
06
03
2024
accepted:
09
07
2024
medline:
5
8
2024
pubmed:
5
8
2024
entrez:
5
8
2024
Statut:
aheadofprint
Résumé
Patients with chronic intestinal failure (CIF) may be predisposed to poor oral health outcomes. This study explored the self-reported oral health status, function, and psychological impacts of oral health of adult patients with CIF, their access to dental care, and how these compare with the broader population. All patients >18 years old receiving home intravenous therapies for CIF were invited to complete a self-reported questionnaire providing information on oral health status and access to oral health services. Collateral information was provided by treating clinicians. Descriptive data analysis was undertaken, including subgroup analysis of clinical characteristics, and was compared with the available population-level data. Twenty-four patients participated. Short gut and dysmotility accounted for 88% of the etiologies of CIF. Respondents reported good preventative oral health behaviors (96%), accessing dental care within the last 12 months (75%), and limited barriers to receiving care. Dry mouth (96%), oral pain (59%), and temperature sensitivity (60%) were commonly reported across the cohort. Smoking history and reduced oral diet were associated with significantly worse self-reported oral health outcomes. Patients with CIF reported worse oral health outcomes despites better oral health access than the general population. Patients with CIF appear to be at risk of poor oral health outcomes, especially where smoking or reduced oral intake are concurrently involved. Clinicians involved in CIF care should be alert to the oral health needs of this population and consider oral and dental health as part of the multidisciplinary care required for optimal CIF care.
Sections du résumé
BACKGROUND
BACKGROUND
Patients with chronic intestinal failure (CIF) may be predisposed to poor oral health outcomes. This study explored the self-reported oral health status, function, and psychological impacts of oral health of adult patients with CIF, their access to dental care, and how these compare with the broader population.
METHODS
METHODS
All patients >18 years old receiving home intravenous therapies for CIF were invited to complete a self-reported questionnaire providing information on oral health status and access to oral health services. Collateral information was provided by treating clinicians. Descriptive data analysis was undertaken, including subgroup analysis of clinical characteristics, and was compared with the available population-level data.
RESULTS
RESULTS
Twenty-four patients participated. Short gut and dysmotility accounted for 88% of the etiologies of CIF. Respondents reported good preventative oral health behaviors (96%), accessing dental care within the last 12 months (75%), and limited barriers to receiving care. Dry mouth (96%), oral pain (59%), and temperature sensitivity (60%) were commonly reported across the cohort. Smoking history and reduced oral diet were associated with significantly worse self-reported oral health outcomes. Patients with CIF reported worse oral health outcomes despites better oral health access than the general population.
CONCLUSION
CONCLUSIONS
Patients with CIF appear to be at risk of poor oral health outcomes, especially where smoking or reduced oral intake are concurrently involved. Clinicians involved in CIF care should be alert to the oral health needs of this population and consider oral and dental health as part of the multidisciplinary care required for optimal CIF care.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 American Society for Parenteral and Enteral Nutrition.
Références
Pironi L, Arends J, Baxter J, et al. ESPEN endorsed recommendations. Definition and classification of intestinal failure in adults. Clin Nutr. 2015;34(2):171‐180.
Lee AM, Gabe SM, Nightingale JM, Burke M. Oral health, dental prophylaxis and catheter related bloodstream infections in home parenteral nutrition patients: results of a UK survey and cohort study. Br Dent J. 2012;212(2):E4.
Pironi L, Boeykens K, Bozzetti F, et al. ESPEN guideline on home parenteral nutrition. Clin Nutr. 2020;39(6):1645‐1666.
Gillanders L, Angstmann K, Ball P, et al. AuSPEN clinical practice guideline for home parenteral nutrition patients in Australia and New Zealand. Nutrition. 2008;24(10):998‐1012.
Osland EJ, McGrath KH, Ali A, et al. A framework to support quality of care for patients with chronic intestinal failure requiring home parenteral nutrition. J Gastroenterol Hepatol. 2020;35(4):567‐576.
Fujita Y, Maki K. Association of feeding behavior with jaw bone metabolism and tongue pressure. Jpn Dent Sci Rev. 2018;54(4):174‐182.
Zaura E, Brandt BW, Prodan A, et al. On the ecosystemic network of saliva in healthy young adults. ISME J. 2017;11(5):1218‐1231.
Alosaimi N, Bernabé E. Amount and frequency of added sugars intake and their associations with dental caries in United States adults. Int J Environ Res Public Health. 2022;19(8):4511.
Penoni DC, Torres SR, Oliveira ML, Farias MLF, Vettore MV, Leão ATT. Untreated osteoporosis and higher FRAX as risk factors for tooth loss: a 5‐year prospective study. J Bone Miner Metab. 2023;41(5):727‐737.
Lee AM, Gabe SM, Nightingale JM, Burke M. Intestinal failure and home parenteral nutrition: implications for oral health and dental care. Clin Nutr. 2013;32(1):77‐82.
International Consortium for Health Outcome Measurement. Adult oral health. Accessed October 18, 2023. https://connect.ichom.org/patient-centered-outcome-measures/adult-oral-health/
Australian Research Centre for Population Oral Health. Australia's Oral Health: National Study of Adult Oral Health 2017–18. The University of Adelaide; 2019.
Department of Health and Aged Care. Rural, remote and metropolitan area. Accessed October 18, 2023. https://www.health.gov.au/topics/rural-health-workforce/classifications/rrma
Department of Health and Aged Care. Health workforce locator. Accessed October 18, 2023. https://www.health.gov.au/resources/apps-and-tools/health-workforce-locator/app?language=en
Gajendra S, McIntosh S, Ghosh S. Effects of tobacco product use on oral health and the role of oral healthcare providers in cessation: a narrative review. Tob Induc Dis. 2023;21(January):1‐16.
Yeung CA. Is the use of tobacco products, especially electronic nicotine delivery systems (ENDS), associated with the incidence of oral health outcomes among US adults? Evid Based Dent. 2023;24(4):161‐162.
Australian Bureau of Statistics. 4831.0.55.001—Tobacco smoking in Australia: a snapshot, 2004–05. Updated November 9, 2009. Accessed November 27, 2023. https://www.abs.gov.au/ausstats/abs@.nsf/mf/4831.0.55.001
Ellegård L, Kurlberg G, Bosaeus I. High prevalence of vitamin D deficiency and osteoporosis in out‐patients with intestinal failure. Clin Nutr. 2013;32(6):983‐987.
Harris R, Hollingworth T, Smith T, McCulloch A, Holmes C, Clarke E. O13 Prevalence of osteoporosis and use of FRAX in patients with intestinal failure. Gut. 2022;71(suppl 1):A7‐A8.
Sager K, Burden S, Lal S. PTU‐123 Prevalence of metabolic bone disease in HPN patients and progression of bone mineral density. Gut. 2017;66(suppl 2):A111‐A112.
Yu B, Wang C‐Y. Osteoporosis and periodontal diseases—an update on their association and mechanistic links. Periodontol 2000. 2022;89(1):99‐113.
von Wowern N, Klausen B, Hylander E. Bone loss and oral state in patients on home parenteral nutrition. JPEN J Parenter Enteral Nutr. 1996;20(2):105‐109.
Terech‐Skóra S, Kasprzyk‐Mazur J, Leyk‐Kolańczak M, et al. Assessment of oral health in long‐term enteral and parenteral nutrition patients: significant aspects of nursing care. Int J Environ Res Public Health. 2023;20(4):3381.
Lopes S, Tavares V, Mascarenhas P, et al. Oral health status of adult dysphagic patients that undergo endoscopic gastrostomy for long term enteral feeding. Int J Environ Res Public Health. 2022;19(8):4827.