The impact of integrating oral health education in cardiac rehabilitation: A randomised controlled trial.

BackgroundDespite the growing body of evidence supporting an association between oral disease and cardiovascular disease (CVD), oral health as a modifiable risk factor for cardiovascular health is rarely addressed. ObjectiveTo determine whether a novel oral health education program improves oral health related behaviours and knowledge of individuals attending cardiac rehabilitation. MethodsThis randomised clinical trial (1:1:1) in Australian public hospitals compared three interventions: 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: no oral health education. All participants received OHI+DOHE after final follow-up. The primary outcome was improvement in oral hygiene, assessed by approximal plaque index (API) at 6 weeks. Secondary outcomes included API reductions at 12 weeks, as well as self-reported changes in oral hygiene behaviours, knowledge, confidence, status, and motivation. ResultsA total of 158 participants were randomised (mean age 62 {+/-} 11 years; 82% males). At six weeks, 77.1% (27/35) of participants receiving OHI+DOHE showed a reduction in API, compared to 26.8% (11/51) receiving usual care (odds ratio [OR] 9.16, 95% CI: 3.34-27.75). Participants receiving DOHE alone showed similar reductions. ConclusionOral health education delivered during cardiac rehabilitation using digital media alone, or in combination with clinician delivered face-to-face messaging improves oral hygiene, behaviours and knowledge among patients with CVD and can be integrated into cardiology care. Trial registrationanzctr.org.au ACTRN12623000449639p