Changes in Periodontal Status after Pandemic-Related Interruptions to Care in a Fragile Cohort

Abstract

Sanative therapy (ST) can be a highly effective first-line therapy for periodontal disease. However, even after successful ST, patients require life-long periodontal maintenance therapy (PMT) to maintain their periodontal health. As a result of the COVID-19 global pandemic, stay-at-home orders and other public health measures resulted in many patients missing or delaying their regularly scheduled PMT appointments. The primary objective of this study was to determine, at 5 to 10 years post-ST, if patients who delayed their appointments as a result of COVID-19 experienced significant changes in periodontal probing depth (PPD), bleeding on probing (BOP), and plaque index (PI) compared to patients without appointment delays. Additionally, lifestyle factors such as dietary intake, physical activity, and oral hygiene behaviors were hypothesized to have been altered because of the COVID-19 pandemic, and interview questions were used to capture these changes. The study was completed at a private periodontal clinic. Patient medical and dental history data was collected retrospectively from patient charts. Due to challenges with recruitment, a subset of the required sample size was studied with findings providing pilot data for a larger future study. Study participants (n = 12) were asked to complete two different physical activity questionnaires, a 24-hour dietary recall, and a supplement and tea questionnaire online. Furthermore, a short virtual interview was used to ask participants how they felt COVID-19 impacted several lifestyle factors. At 5 to 10 years post-ST, a short delay in PMT appointments of 2 – 6 months did not significantly affect PPD, BOP and PI. Most participants reported changes to physical activity (80%) and diet (80%), but no changes to oral hygiene behaviors (90%). Overall, physical activity, diet, and body mass index data in the study sample closely aligned with findings from larger studies that have assessed these aspects in the Canadian population. This pilot study should be used to design future studies aimed at investigating the relationship between periodontal health and behavioral changes resulting from the COVID-19 pandemic.