Abstract
Previous studies provide conflicting evidence as to whether there is an association between poor oral health and an increased risk of myocardial infarction. The aim of the study was to deepen knowledge of the association between oral health and myocardial infarction risk using a large (n = 20,133), prospective, and population-based cohort in Uppsala, Sweden. Oral health was determined during a clinical dental examination at entry into the cohort in 1973/74. Individuals were followed through linkage with the Swedish National Patient Register, Cause of Death Register and Emigration Register. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) for total, non-fatal and fatal myocardial infarction events. Increased risks of total, non-fatal and fatal myocardial infarction events among individuals with fewer reference teeth at examination, more dental plaque and a borderline significant increased risk among individuals with oral lesions were observed. Adjustment for multiple potential confounding factors did not change the results appreciably. However, the observed HRs generally decreased towards one when the analysis was confined to non-tobacco users only. The results from this study indicate that poor oral health is associated with a slightly increased risk of myocardial infarction; however, these results may be partly explained by residual confounding.
Highlights
Previous studies provide conflicting evidence as to whether there is an association between poor oral health and an increased risk of myocardial infarction
To ensure high specificity of the outcome, we only considered myocardial infarction (MI) recorded as the main diagnosis in the Patient Register or as the underlying cause of death in the Cause of Death Register; this approach has been used previously[21,22]
Dental plaque and presence of oral lesions were correlated to the age of the individuals at cohort entry
Summary
Previous studies provide conflicting evidence as to whether there is an association between poor oral health and an increased risk of myocardial infarction. Non-fatal and fatal myocardial infarction events among individuals with fewer reference teeth at examination, more dental plaque and a borderline significant increased risk among individuals with oral lesions were observed. Previous studies have observed an increased risk of myocardial infarction (MI) with various measures of oral health including tooth loss[11], periodontal diseases[12], and dental plaque[13]. To investigate the association between oral health and the risk of MI events, we examined the hazards of total, non-fatal and fatal incident MI events in relation to the number of teeth, presence of dental plaque and presence of oral lesions in a large, prospective, and population-based cohort in Uppsala, Sweden
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