TY - JOUR
T1 - Association Between Self-Reported Dental Hygiene Practices and Dental Procedure-Related Recurrent Angioedema Attacks in HAE Subjects
T2 - A Multicenter Survey
AU - Singh, Umesh
AU - Lumry, William R.
AU - Busse, Paula
AU - Wedner, H. James
AU - Banerji, Aleena
AU - Craig, Timothy J.
AU - Li, H. Henry
AU - Tachdjian, Raffi
AU - Jacobs, Joshua S.
AU - Riedl, Marc A.
AU - Davis-Lorton, Mark
AU - Christiansen, Sandra C.
AU - Zuraw, Bruce L.
AU - Bernstein, Jonathan A.
N1 - Funding Information:
Conflicts of interest: W. R. Lumry is on the Medical Advisory Board for US Hereditary Angioedema Association. P. Busse reports grants and personal fees from CSL Behring, Shire/Takada, Pharming, BioCryst, Novartis, and ResTORbio; personal fees from Pearl Therapeutics, CVS Health, Law offices of Levin, Riback, Adelman, and Flangel, Astra Zeneca, GSK, Vedder Price, and Fresenius; and nonfinancial support from Hereditary Angioedema Association and American Academy of Allergy, Asthma, and Immunology, outside the submitted work. H. James Wedner reports grants and personal fees from BioCryst and CSL; and grants from Takeda, outside the submitted work. A. Banerji reports grants from Takeda and BioCryst; and personal fees from Takeda, BioCryst, CSL, Pharming, Kalvista, and Pharvaris, outside the submitted work. T. J. Craig reports grants, personal fees, and other from CSL Behring and Takeda; grants and personal fees from Dyax, BioCryst, and Pharming; personal fees from Grifols; and grants and nonfinancial support from GSK, Regeneron, and Novartis/Genetech, outside the submitted work; and is on the Medical Advisory Board for HAE-A of America, AAAAI Board, and ALA Mid Atlantic Board. H. Henry Li reports grants, personal fees, and nonfinancial support from BioCryst, CSL Behring, Pharming, and Shire/Takeda, outside the submitted work. M. A. Riedl reports grants and personal fees from CSL Behring, Pharming, Takeda/Shire, and BioCryst; grants from Ionis; and personal fees from Adverum, Attune, Kalvista, and Pharvaris, outside the submitted work; and is on the US Hereditary Angioedema Association Medical Advisory Board (uncompensated). S. C. Christiansen reports grants from U. Cincinnati, during the conduct of the study; and personal fees from CSL Behring, Takeda, Pharming, and BioCryst, outside the submitted work. B. L. Zuraw reports grants from U. Cincinnati, during the conduct of the study; personal fees from CSL Behring, Takeda, Adverum, Pharming, BioCryst, and Attune; and other from Ionis, outside the submitted work. J. A. Bernstein reports personal fees for consulting, speaking, and serving as a principal investigator for Shire/Takeda, CSL Behring, and Pharming; reports consulting and speaker fees from Optinose; reports personal fees for speaking and serving as a sub-investigator for ALK and GlaxoSmithKline; reports personal fees outside the submitted work for consulting, speaking, and serving as a principal investigator for Astra Zeneca, Sanofi-Regeneron, and Novartis/Genentech; and is a consultant and principal investigator for Merck, Biocyst, Kalvista, and Ionis. The rest of the authors declare that they have no relevant conflicts of interest.
Publisher Copyright:
© 2020 American Academy of Allergy, Asthma & Immunology
PY - 2020/10
Y1 - 2020/10
N2 - Background: Hereditary angioedema (HAE) symptoms may be triggered by dental procedures, thereby complicating dental care in individuals affected by the condition. Objective: This study investigated the self-perceived dental care needs, perceived susceptibility to acute angioedema (AE) attacks after dental procedures, and dental care behavior of patients with HAE. Methods: A self-administered semistructured web-based questionnaire was distributed to 250 adult patients with HAE (type 1 or 2; 88% type 1) and 256 matched non-HAE controls. Data were analyzed using stratified χ2 tests, logistic regression, and classification trees. Results: A total of 46.4% of HAE versus 55.5% of control patients had dental visits within 6 months (P =.04). Dental insurance was a barrier to seeking routine dental visits among both groups. However, significantly fewer patients with HAE had routine dental visits within 6 months despite having dental insurance compared with control patients (48% vs 60%, P =.01). Within the HAE group, a significantly greater number of patients with dental visits at intervals greater than 6 months had a history of recurrent postprocedural AE attacks (odds ratio [OR]: 3.9 [1.7, 8.8], P =.0005) and used antibacterial toothpaste more frequently than those without recurrent AE attacks (OR: 4.7 [1.5, 15.4], P =.005). Conclusions: These data support the hypothesis that patients with HAE who are predisposed to having AE episodes in response to medical or physical trauma visit the dentist less and engage in specific oral hygiene practices more frequently than matched control patients and patients with HAE who reported that they were less likely to swell after a dental procedure.
AB - Background: Hereditary angioedema (HAE) symptoms may be triggered by dental procedures, thereby complicating dental care in individuals affected by the condition. Objective: This study investigated the self-perceived dental care needs, perceived susceptibility to acute angioedema (AE) attacks after dental procedures, and dental care behavior of patients with HAE. Methods: A self-administered semistructured web-based questionnaire was distributed to 250 adult patients with HAE (type 1 or 2; 88% type 1) and 256 matched non-HAE controls. Data were analyzed using stratified χ2 tests, logistic regression, and classification trees. Results: A total of 46.4% of HAE versus 55.5% of control patients had dental visits within 6 months (P =.04). Dental insurance was a barrier to seeking routine dental visits among both groups. However, significantly fewer patients with HAE had routine dental visits within 6 months despite having dental insurance compared with control patients (48% vs 60%, P =.01). Within the HAE group, a significantly greater number of patients with dental visits at intervals greater than 6 months had a history of recurrent postprocedural AE attacks (odds ratio [OR]: 3.9 [1.7, 8.8], P =.0005) and used antibacterial toothpaste more frequently than those without recurrent AE attacks (OR: 4.7 [1.5, 15.4], P =.005). Conclusions: These data support the hypothesis that patients with HAE who are predisposed to having AE episodes in response to medical or physical trauma visit the dentist less and engage in specific oral hygiene practices more frequently than matched control patients and patients with HAE who reported that they were less likely to swell after a dental procedure.
KW - Dental hygiene
KW - Health belief model
KW - Hereditary angioedema
KW - Postdental procedure angioedema attacks
KW - Questionnaire survey
KW - Routine dental visit
KW - Teeth brushing frequency
UR - http://www.scopus.com/inward/record.url?scp=85088808898&partnerID=8YFLogxK
U2 - 10.1016/j.jaip.2020.05.041
DO - 10.1016/j.jaip.2020.05.041
M3 - Article
C2 - 32534150
AN - SCOPUS:85088808898
VL - 8
SP - 3162-3169.e5
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
SN - 2213-2198
IS - 9
ER -