European Journal of Cardiovascular Medicine

Cardiovascular diseases (CVDs) are a major public health concern and one of the leading causes of morbidity and mortality worldwide. According to the World Health Organization (WHO), CVDs account for approximately 17.9 million deaths annually, representing nearly 32% of all global deaths (1). Several risk factors, including hypertension, diabetes, smoking, and poor oral health, have been implicated in the progression of cardiovascular diseases (2). Emerging evidence suggests that periodontitis and other oral infections may contribute to systemic inflammation, increasing the risk of atherosclerosis and other cardiovascular complications (3).

Oral health plays a crucial role in maintaining overall well-being. However, access to dental care in rural areas remains limited due to socioeconomic disparities, lack of awareness, and inadequate healthcare facilities (4). Studies have indicated that rural populations are more prone to oral health issues such as untreated dental caries and periodontal disease, which may further exacerbate existing systemic conditions, including CVDs (5). The bidirectional relationship between periodontal disease and cardiovascular health underscores the importance of dental interventions in managing systemic conditions (6).

In India, where a significant proportion of the population resides in rural regions, the burden of CVDs continues to rise. Despite various public health initiatives, awareness and accessibility to oral healthcare services remain inadequate (7). Varanasi, a district with a considerable rural population, presents unique challenges in terms of healthcare infrastructure and disease management. Identifying the prevalence of dental treatment among individuals with CVDs in these areas can help in formulating targeted preventive strategies.

This study aims to assess the prevalence of dental treatment among individuals diagnosed with cardiovascular diseases in the rural areas of the Varanasi district. It also seeks to explore the relationship between oral health status and the severity of CVDs, emphasizing the need for integrated healthcare approaches.

Study Design and Setting

This cross-sectional study was conducted in the rural areas of Varanasi district to evaluate the prevalence of dental treatment among individuals diagnosed with cardiovascular diseases (CVDs). The study was carried out over a period of six months in collaboration with local healthcare centers and community health workers.

Study Population and Sampling

A total of 500 participants diagnosed with CVDs were selected using a stratified random sampling method. The inclusion criteria were individuals aged 35 years and above, medically diagnosed with a cardiovascular condition, and residing in rural areas of Varanasi for at least five years. Exclusion criteria included individuals with congenital heart diseases, those undergoing ongoing periodontal treatment, and patients with debilitating systemic illnesses that could interfere with oral examinations.

Data Collection

Participants were interviewed using a structured questionnaire covering demographic information, medical history, oral health habits, and previous dental treatments. Clinical oral examinations were performed by trained dental professionals to assess periodontal status, presence of dental caries, and other oral health conditions. The periodontal status was evaluated using the Community Periodontal Index (CPI), while the decayed, missing, and filled teeth (DMFT) index was used to assess dental caries.

Ethical Considerations

Ethical approval for the study was obtained from the institutional ethics committee. Informed consent was taken from all participants before data collection, ensuring confidentiality and voluntary participation.

Data Analysis

The collected data were analyzed using SPSS software version 25. Descriptive statistics such as mean, standard deviation, and percentage distribution were used to summarize the findings. The chi-square test was applied to determine associations between oral health status and cardiovascular conditions, and logistic regression analysis was conducted to assess risk factors influencing oral health in CVD patients. A p-value of less than 0.05 was considered statistically significant.

Demographic Characteristics of the Study Population

A total of 500 participants diagnosed with cardiovascular diseases (CVDs) were included in the study. The mean age of the participants was 56.4 ± 10.2 years, with a male-to-female ratio of 1.3:1. The majority (62%) belonged to the lower socioeconomic group, and 78% had limited access to dental care facilities. Among the participants, 55% had hypertension, 40% had diabetes, and 35% were smokers.

Table 1: Demographic Characteristics of Study Participants

(Table 1 shows the demographic distribution of participants, highlighting key characteristics such as age, gender, and comorbidities.)

Oral Health Status and Dental Treatment Prevalence

Among the participants, 65% exhibited poor oral hygiene, with 42% suffering from moderate-to-severe periodontitis. Untreated dental caries was observed in 30% of individuals, while only 25% had received professional dental treatment in the past year. The majority (70%) had inadequate awareness regarding the link between oral health and cardiovascular diseases.

Table 2: Oral Health Status of Study Participants

(Table 2 illustrates the oral health status of the participants, indicating a high prevalence of periodontal disease and low treatment accessibility.)

Association Between Oral Health and Cardiovascular Disease Severity

A statistically significant association was observed between the severity of periodontitis and CVD status (p < 0.05). Participants with severe periodontitis had a 2.5 times higher risk of worsening cardiovascular conditions compared to those with good oral health. The logistic regression analysis further confirmed that smoking, diabetes, and poor oral hygiene were significant predictors of severe periodontitis in CVD patients.

Table 3: Association Between Oral Health Status and CVD Severity

(Table 3 demonstrates the correlation between oral health status and the severity of cardiovascular diseases, indicating a significant association.)

These findings emphasize the need for increased awareness, early dental interventions, and integrated healthcare strategies for patients with cardiovascular diseases in rural areas of Varanasi.

The findings of this study highlight a significant prevalence of poor oral health among individuals diagnosed with cardiovascular diseases (CVDs) in rural areas of Varanasi. A substantial proportion of the study population exhibited moderate to severe periodontitis, untreated dental caries, and poor oral hygiene practices, emphasizing the need for improved oral health awareness and accessibility to dental care. Several studies have established a strong correlation between periodontal disease and CVDs, primarily due to the role of chronic inflammation in the progression of atherosclerosis and other cardiovascular complications (1,2).

One of the key observations in this study was the low prevalence of professional dental treatment among individuals with CVDs. Only 25% of participants had undergone dental treatment in the past year, reflecting inadequate oral healthcare services in rural settings. Limited access to dental care, financial constraints, and lack of awareness are among the primary barriers preventing individuals from seeking timely dental interventions (3,4). Previous research suggests that oral health disparities are more pronounced in low-income and rural populations, with limited healthcare infrastructure contributing to the burden of untreated dental conditions (5,6).

Our results also revealed that 70% of the participants were unaware of the relationship between oral health and cardiovascular diseases. This is concerning given the growing body of evidence supporting the role of periodontal disease as a risk factor for CVDs (7,8). The presence of chronic periodontal infections leads to increased systemic inflammation, elevated levels of C-reactive protein (CRP), and endothelial dysfunction, all of which contribute to cardiovascular complications (9,10). A meta-analysis by Sanz et al. (11) reported that individuals with periodontitis have a significantly higher risk of developing coronary artery disease, reinforcing the need for integrated medical and dental care approaches.

Furthermore, smoking and diabetes were identified as significant predictors of periodontal disease severity among CVD patients in our study. Smoking is well-documented as a major risk factor for both periodontal disease and cardiovascular conditions, exacerbating systemic inflammation and impairing immune responses (12). Similarly, diabetes has been linked to poor periodontal health, with hyperglycemia contributing to increased susceptibility to infections and delayed wound healing (13,14). These findings underscore the necessity of comprehensive health education programs targeting high-risk populations to promote oral hygiene and lifestyle modifications.

A significant association was observed between the severity of periodontitis and CVD status, with individuals suffering from severe periodontitis exhibiting a 2.5 times higher risk of worsening cardiovascular conditions. These results are consistent with previous studies that have demonstrated a bidirectional relationship between periodontitis and cardiovascular diseases, suggesting that effective periodontal treatment may contribute to improved cardiovascular health outcomes (15,16). A randomized controlled trial by Tonetti et al. (17) found that non-surgical periodontal therapy resulted in a significant reduction in systemic inflammation markers and improved endothelial function in patients with CVDs.

Given these findings, it is imperative to integrate oral health into routine medical care for individuals with cardiovascular diseases. The implementation of community-based oral health programs, training of primary healthcare providers in basic dental care, and inclusion of periodontal assessments in cardiovascular disease management protocols can significantly improve patient outcomes (18,19). Additionally, public health initiatives should focus on increasing accessibility to dental services in rural areas through mobile dental units and tele-dentistry programs (20).

This study has certain limitations, including its cross-sectional design, which does not establish causality between oral health and CVD progression. Additionally, self-reported data on oral health behaviors may introduce response bias. However, the study provides valuable insights into the oral health status of CVD patients in rural settings and highlights the need for further longitudinal research to explore the impact of oral health interventions on cardiovascular disease outcomes.

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