Cross-Sectional Study of Periodontal Oral Dental Foci of Infection (PODFI) in Medically Compromised Patients at Lille University Hospital

Oral dental foci of infection (ODFI), particularly those of periodontal origin, can trigger systemic inflammatory responses that may cause bacteremia for medically compromised patients. Although guidelines recommend detection and elimination of these foci, precise data on the distribution of periodontal oral dental foci of infection (PODFI) risk within these populations remain scarce. This study aimed to describe periodontal sources of infection in medically compromised patients using a periodontal examination and follow-up form and a recently developed PODFI risk levels classification.

This observational, retrospective, cross-sectional, single-center study evaluated medically compromised patients with periodontitis in the dental surgery department of the Lille University Hospital between September 2024 and September 2025. Periodontitis was diagnosed according to the 2017 Classification of Periodontal Diseases established at the 2017 World Workshop. The primary outcome was the distribution of PODFI risk levels (moderate, high, very high). Secondary outcomes aimed to describe periodontal conditions in a specific population of medically compromised patients.

Thirty-nine patients were included in this study. Evaluation of PODFI risk (n = 34) revealed a predominance of moderate-risk profiles (67.6%) and a significant proportion of high-risk profiles (32.4%); no low-risk or very high-risk profiles were observed. Periodontal inflammation was very common (92%), with a median of 26 bleeding on probing (BOP) sites and 71 plaque-positive sites, showing a positive correlation (R = 0.52, p = 0.002).

Severe and active forms of periodontitis predominated (n = 39), with 74.4% of cases classified as stage III (28.2%) or stage IV (46.2%), and grade B was the most common (56.4%), followed by grade C (38.5%).

Medically compromised patients have a high prevalence of severe and active periodontitis, with nearly one-third of them classified as being at high risk for infection. The recently developed periodontal oral dental foci of infection (PODFI) classification provides a structured and clinically relevant tool for stratifying infection risk and guiding treatment decisions. Prospective multicenter studies are needed to confirm the validity of these PODFI risk levels.