Abstract
We aimed to evaluate the risk of coronary heart disease (CHD) according to dental caries status in middle-aged patients using a population-based cohort database containing medical/dental claims, health examination, and death records in the Republic of Korea. A total of 234,597 patients were identified in the database who were without history of cardiovascular disease, including 104,638 patients without dental caries, 41,696 with incipient/moderate stage dental caries, and 88,262 advanced/severe dental caries. We used Cox proportional hazards model adjusted for sociodemographic, lifestyle, and medical characteristics to compute hazard ratio (HR) and 95% confidence intervals (95% CI) for CHD according to severity of dental caries. During 1,491,190 person-years of follow-up, there were a total of 6,015 CHD events. After adjustment for potential confounders, patients in the highest quartile of outpatient visits for advanced/severe stage dental caries was associated with an increase in CHD risk (HR = 1.13; 95% CI: 1.04–1.22) as compared with patients without dental caries. When the analysis was restricted to the patients with advanced/severe dental caries, dose-response relationship between number of outpatient visits for dental caries and risk of CHD was observed (Ptrend: <0.001). Prevention and control of dental caries might be worth promoting in clinical practice to prevent CHD.
Highlights
Several risk factors have been established for coronary heart disease (CHD) by the studies that examined a wide range of attributes such as genetic marker, lifestyle, and health status[1,2,3,4]
Compared with the patients without dental caries, the risk estimate for CHD was the highest among the patients with the most frequent outpatient visits (Quartile 4) for advanced/severe stage dental caries was (HR = 1.13; 95% confidence intervals (95% CI): 1.04–1.22) after adjusting for potential confounders (Table 2)
Additional cohort analysis matched for age, sex, insurance premium, residential area, and year of diagnosis for dental caries generated similar results. This nationally representative cohort study provides an overview of the association between severity of dental caries and risk of CHD among middle-aged men and women in the Republic of Korea
Summary
Several risk factors have been established for coronary heart disease (CHD) by the studies that examined a wide range of attributes such as genetic marker, lifestyle, and health status[1,2,3,4]. Few studies have evaluated association of dental caries with atherosclerosis and cardiometabolic risk factors with a small number of patients[8,9]. These studies are susceptible to selection bias and lacks generalizability. These studies did not examine the association between dental caries status and CHD in their population sample. We used a large representative sample of medical/dental claims data linked to health examination records and death registry to evaluate the association between severity of dental caries and CHD in middle aged men and women
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