Association between self-reported oral health, tooth loss and atherosclerotic burden

Maximiliano Schünke Gomes,Carla Helena Augustin Schwanke,Patrícia Chagas,Dalva Maria Pereira Padilha,Paulo Caramori,Juliana Balbinot Hilgert,Fernando Neves Hugo

doi:10.1590/s1806-83242012005000019

Abstract

Previous studies have suggested that oral diseases may influence the development of atherosclerosis. The aim of this study was to test the hypothesis that poor self-reported oral health (SROH) and tooth loss are positively associated with coronary atherosclerotic burden (CAB). 382 consecutive subjects undergoing coronary angiography were included. Socio-demographic characteristics, cardiovascular risk factors and oral health status were collected using a standardized questionnaire, including data on SROH and use of dental prosthesis. Number of teeth and anthropometric measures were collected through clinical examinations. CAB at coronary angiography was quantified using the Friesinger score (FS). Prevalence ratios (PR) were calculated with Poisson regression analyses. Mean age was 60.3 ± 10.8 years, with 63.2% males. In the bivariate analysis, there was a significant association (p < 0.05) between CAB and age (> 60y) (PR = 1.01, 95%CI = 1.02-1.16), male gender (PR = 1.11, 95%CI = 1.03-1.19), smoking (PR = 1.08, 95%CI = 1.01- 1.16), hypertension (PR = 1.12, 95%CI = 1.03-1.22), diabetes (PR = 1.17, 95%CI = 1.05-1.21), poor SROH (PR = 1.22, 95%CI = 1.02-1.46) and tooth loss (< 20 teeth present) (PR = 1.10, 95%CI = 1.02-1.19). The use of dental prosthesis was not associated with CAB. The multivariate models, adjusted for age, gender, smoking, hypertension, diabetes and dyslipidemia showed that poor SROH (p = 0.03) and tooth loss (p = 0.02) were independently associated with CAB, confirming the study hypothesis.

Highlights

Epidemiological studies have suggested that chronic periodontal disease,[1,2,3,4] lesions of endodontic origin[5] and tooth loss[6] are associated with cardiovascular disease (CVD) and mortality.The triggering of an inflammatory response by infectious agents is a potential mechanism correlating infection to the acceleration of atherosclerosis.[7]
Dental variables revealed that nearly 45% of the participants reported poor or fair oral health status, more than 67% wore dental prosthesis, and only 33% had ≥ 20 teeth
In the unadjusted analysis (Table 1), there was a significant association between Coronary atherosclerotic burden (CAB) and age (PR = 1.01, 95% CI = 1.02–1.16), gender (PR = 1.11, 95% CI = 1.03–1.19), smoking (PR = 1.08, 95% CI = 1.01–1.16), hypertension (PR = 1.12, 95% CI = 1.03– 1.22), diabetes (PR = 1.17, 95% CI = 1.05–1.21), poor self-reported oral health (SROH) (PR = 1.22, 95% CI = 1.02–1.46) and number of teeth < 20 (PR = 1.10, 95% CI = 1.02– 1.19)

Summary

Introduction

Epidemiological studies have suggested that chronic periodontal disease,[1,2,3,4] lesions of endodontic origin[5] and tooth loss[6] are associated with cardiovascular disease (CVD) and mortality.The triggering of an inflammatory response by infectious agents is a potential mechanism correlating infection to the acceleration of atherosclerosis.[7].

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Results

Conclusion