Oral Hygiene And Heart Disease?
October is National Dental Hygiene Month. What does that have to do with cardiovascular disease (CVD)? The connection between oral health and CVD has been discussed for over a century.
We know that both periodontal disease and CVD share risk factors of cigarette smoking, age, and diabetes mellitus. In addition, there are pathogenic mechanisms that have been suggested as links between CVD and periodontal disease. Numerous inflammatory markers including C-reactive protein, lipoprotein-associated phospholipase A2, fibrinogen, and interleukin 6 have consistently been shown to be related to increases in clinical cardiovascular events. Periodontal inflammation is also associated with elevated inflammatory markers.
In 2012, the American Heart Association reviewed years of literature that suggested that there is an association with periodontal disease and atherosclerotic vascular disease, but these were observational studies and did not demonstrate the existence of a causal relationship. Reducing systemic inflammation and endothelial dysfunction by treating periodontal disease did not show prevention or modification of CVD in the short-term studies that were reviewed. The findings were published in Circulation.1
However, with more than 1 billion bacteria in the mouths of most adults, we know that bacteria in the oral cavity can be an area that contributes to the risk of endocarditis. The American College of Cardiology/American Heart Association 2008 guideline update on valvular heart disease focusing on infective endocarditis suggests that "maintenance of optimal oral health and hygiene may reduce the incidence of bacteremia from daily activities and is more important than prophylactic antibiotics for a dental procedure to reduce the risk of infective endocarditis." For those patients at high risk of endocarditis, however, antibiotic prophylaxis is recommended.2
A healthy mouth is an important part of good health. So what should we tell our patients?
* professional teeth cleaning every 6 months-smoking and chewing tobacco cessation
* Brush and floss your teeth a minimum of twice daily.
* Limit alcohol consumption
* eat a healthy diet and limit between-meal snacks.
* Tell your dentist if you are taking medications such as decongestants, antihistamines, pain-killers, calcium-channel blockers, and diuretics, which can cause dry mouth, reducing saliva production; saliva neutralizes acids that are produced by bacteria, and this protects the oral mucosa.
REFERENCES:
1. Lockhart PB, Boler AF, Papapanou PN, et al. Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association? A scientific statement from the American Heart Association. Circulation. 2012;125:2520-2544.
2. Nishimura RA, Carabello BA. ACC/AHA 2008 guideline update on valvular heart disease: focused update on infective endocarditis. Circulation. 2008;118:887-896.
PCNA Chapter Spotlight
The Minnesota-Wisconsin Chapter of PCNA recently welcomed a new chapter leader, Carol Marsh, DNP, APRN, CNP, CLS. On May 9, 2015, Carol and colleagues Laurel Ash, DNP, APRN, CNP, and Catherine Miller, DNP, APRN, CNP, led a chapter event: Power to Prevent: Cardiovascular Risk Reduction Across the Lifespan. This outstanding educational opportunity convened area nurse practitioners, physician assistants, and registered nurses while providing 2.75 contact hours for attendees.
Recognizing that coronary artery disease develops over decades, the presenters advocated that primary prevention strategies should begin with children and continue across the life-span. Current guidelines pertaining to cardiovascular risk reduction were reviewed along with techniques to engage children and adults to practice heart-healthy lifestyles. The event concluded with an exercise in mindful listening and progressive relaxation, followed by a video example of healthcare coaching with clients. This networking and educational meeting also celebrated the coinciding National Nurses Week with refreshments to honor the contributions of our nursing colleagues. More information about this chapter can be found at http://pcna.net/member-center/chapters/pcna-chapters/minnesota-wisconsin-chapter.
PCNA currently has 25 active chapters and 12 petitioning chapters throughout the United States and Canada. Chapters are an extension of the national office that provide educational opportunities and foster local networking within regions. Contact PCNA to find a chapter near you or if you are interested in starting a chapter in your area.
Minnesota-Wisconsin Chapter leader Carol Marsh, Catherine Miller, Laurel Ash.
Fall Learning Series: Therapies That Work
This fall, PCNA is offering continuing education programs in cities across the country around the theme of "Therapies That Work: Translating Their Optimal Use Into Clinical Practice." The series of talks aims to deliver clinically relevant information on Saturday that practitioners can use on Monday. Topics will include the secondary prevention cocktail, new tools for lipid treatment, and managing venous thromboembolism.
Join us for free, half-day sessions, where you can network with colleagues and earn 2.25 continuing education contact hours, with 1.25 hours of pharmacology credit. The 2015 dates and locations are as follows:
Denver, Colorado; September 19
Fort Worth, Texas; September 26
Sacramento, California; October 3
Cincinnati, Ohio; October 10
Chicago, Illinois; October 17
Jacksonville, Florida; October 24
Philadelphia, Pennsylvania; October 31
To register or learn more, visit pcna.net/fls.
New At The 2016 Annual Symposium
Mark your calendars for the 22nd Annual Symposium, scheduled for April 14 to 17, 2016 in Orlando, Florida. We have a number of new features this year worth noting.
The "footprint" of the 2016 meeting will be shifted. The annual symposium will open on Friday morning and end on Sunday at 12:30 PM. The pharmacology preconference will be on Thursday afternoon from 12:30 to 5:30 PM. We are making this change in response to many of our members who report that difficulty getting time out of the clinic setting has kept them from attending. We hope that having a larger portion of the conference over two weekend days will be helpful.
Other changes to 2016's event include the addition of three 2-hour "skill-building" concurrent sessions. We are making a strong effort to provide cardiovascular nurses the most critical "need to know" information and continuing the PCNA tradition of hosting star-quality faculty with cutting-edge and inspirational content.
Some key dates are as follows:
November 1, 2015
Abstract submission closes
Scholarship submission deadline
Award nomination deadline
March 15, 2016
Early bird registration deadline
Now Accepting Abstracts
We invite healthcare professionals involved in quality improvement and innovation projects or original data-based research related to cardiovascular risk reduction and disease management to submit an abstract for a poster presentation at the PCNA 2016 Annual Symposium. PCNA is proud to provide this forum for members and colleagues to share their ideas and best practices.
The purpose of the poster session is to present original data-based research findings and share innovative ideas for successful approaches to cardiovascular risk reduction and disease management.
* Two outstanding written abstracts will be selected for oral presentations and published in the Journal of Cardiovascular Nursing.
* Six outstanding posters abstracts will be published in the Journal of Cardiovascular Nursing.
* All presenters and winners will be recognized during PCNA General Sessions on Saturday, April 16.
* All submissions will be eligible for selection to participate in a Moderated Poster Session at the PCNA Annual Symposium. Those chosen to participate in the moderated session would each be allotted 5 minutes to present their work and 5 minutes to answer questions.
There are 2 categories for submission: data-based research and innovation in patient care. Only original abstracts not previously published or presented prior to submitting to PCNA will be considered. Submission of an abstract constitutes a commitment by the author to present a poster if accepted.
Individuals may submit their abstract online at http://www.pcna.net/abstracts. The deadline for submission is November 1, 2015.
To help you prepare, PCNA offers an Excellence in Nursing Leadership on-demand webinar series that includes a course on Writing Strong Abstracts for Professional Conferences. You can find it online at http://www.pcna.net/online-edcuation/writing-strong-abstracts.