An analysis of the level of dental care in cardiac patients at risk for infective endocarditis.

Three hundred and thirty-eight cardiac patients, at risk of infective endocarditis, filled in a questionnaire consisting of a series of questions on their social, educational, familial, professional, medical and dental history and also on their level of dental care. Univariate (chi-square test) and stepwise discriminant analysis were applied to evaluate the factors related to or responsible for the presence or absence of a sufficient level of dental care, defined as at least one dentist visit per year and once daily teeth brushing. An acceptable level of dental care was present in one third of the dentate but almost nonexistent in edentulous patients. Univariate analysis revealed that in dentate patients level of education, knowledge of endocarditis prophylaxis, previous cardiac surgery, time since first heart operation and type of previous operation (artificial valve surgery) were significantly related to the level of dental care. Level of education, knowledge of endocarditis prophylaxis and time since first heart operation were withheld as independent factors by discriminant analysis. A discriminant score was calculated for each patient which permitted classification of the patients in two groups: one with a very high chance for absence of appropriate dental care and one with an equal chance for sufficient or insufficient care. Patients were also classified according to the number of risk factors. An answer to one of the 3 variables, selected by discriminant analysis, unfavorable to the presence of sufficient dental care, was considered a risk factor. Patients with two risk factors had a very high chance for the absence of sufficient dental care; in those with 0 or 1 factor, chances were divided between sufficient and insufficient dental care.