Reducing inflammatory risk with oral health education. A pilot randomised controlled trial

Abstract

AIM: To evaluate whether oral health education improves oral health-related behaviours and knowledge of individuals attending cardiac rehabilitation services. METHODS: This was a randomised, dual centre, parallel design, single blind, clinical trial, taking place in cardiac rehabilitation out-patient clinics. Participants (>=18 years of age, >= 1 teeth, approximal plaque index (API) of >=60%, with cardiovascular disease) were randomised (1:1:1) into one of three arms: Group A) individualised oral hygiene instruction (OHI) combined with a digital oral health education (DOHE) package, Group B) DOHE alone, or Group C) usual care/control - no education. The primary outcome was improvement in oral hygiene, assessed by API at 6 weeks. Secondary outcomes included API reduction at 6 and 12-weeks across all study groups, self-reported changes in oral hygiene behaviours, confidence, motivation, and knowledge. RESULTS: A total of 158 were randomised (mean age 62+/-11 years; 82% male). At 6 weeks, 77.1% of participants receiving OHI+DOHE showed a reduction in API, compared to 26.8% receiving usual care (odds ratio (OR) 9.16, 95% CI: 3.34-27.75, p<0.001). This effect persisted at 12 weeks. Participants receiving DOHE alone showed similar reductions at 6 weeks compared to usual care (OR 4.72, 95% CI: 1.88-12.5, p<0.001), but no significant effect was observed at 12 weeks. Self-reported outcomes also improved, with no adverse events detected. CONCLUSIONS: Oral health education provided face-to-face and/or using digital technology effectively improves oral hygiene, behaviours and knowledge in patients attending cardiac rehabilitation clinics. The findings support integrating oral health interventions into cardiac care to enhance patient outcomes.