Dental infection in vascular surgical patients

Seventy patients, 18 women and 52 men of mean age 68 (range 52-81) years, with vascular disease were studied using the Community Periodontal Index of Treatment Needs (CPITN). Twenty-six were edentulous and 44 dentate; 32 dentate patients were wearing partial dentures. All had occlusive peripheral arterial disease (ankle:brachial pressure index less than 0.9) or aortic aneurysm. No significant periodontal pathology was found in edentulous patients. Of the dentate patients, 28 were in the significant pathology range (CPITN 4) and 12 were in the moderate pathology group (CPITN 3); only four had no significant pathology (CPITN 0-2). As a proportion of prosthetic vascular graft infections may be due to dental sepsis, surgeons should consider referral for dental assessment before elective bypass grafting and patients should be warned about the importance of dental care after operation.