Poor oral health has been linked to coronary heart disease (CHD). Clustering clinical oral conditions routinely recorded in adults may identify their CHD risk profile. Participants from the Paris Prospective Study 3 received, between 2008 and 2012, a baseline routine full-mouth clinical examination and an extensive physical examination and were thereafter followed up every 2 y until September 2020. Three axes defined oral health conditions: 1) healthy, missing, filled, and decayed teeth; 2) masticatory capacity denoted by functional masticatory units; and 3) gingival inflammation and dental plaque. Hierarchical cluster analysis was performed with multivariate Cox proportional hazards regression models and adjusted for age, sex, smoking, body mass index, education, deprivation (EPICES score; Evaluation of Deprivation and Inequalities in Health Examination Centres), hypertension, type 2 diabetes, LDL and HDL serum cholesterol (low- and high-density lipoprotein), triglycerides, lipid-lowering medications, NT-proBNP and IL-6 serum level. A sample of 5,294 participants (age, 50 to 75 y; 37.10% women) were included in the study. Cluster analysis identified 3,688 (69.66%) participants with optimal oral health and preserved masticatory capacity (cluster 1), 1,356 (25.61%) with moderate oral health and moderately impaired masticatory capacity (cluster 2), and 250 (4.72%) with poor oral health and severely impaired masticatory capacity (cluster 3). After a median follow-up of 8.32 y (interquartile range, 8.00 to 10.05), 128 nonfatal incident CHD events occurred. As compared with cluster 1, the risk of CHD progressively increased from cluster 2 (hazard ratio, 1.45; 95% CI, 0.98 to 2.15) to cluster 3 (hazard ratio, 2.47; 95% CI, 1.34 to 4.57; P < 0.05 for trend). To conclude, middle-aged individuals with poor oral health and severely impaired masticatory capacity have more than twice the risk of incident CHD than those with optimal oral health and preserved masticatory capacity (ClinicalTrials.gov NCT00741728).

Objective: The mechanisms underlying the association between low number of masticatory units and cardiovascular disease remain unclear. Under a nutritional framework, we hypothesized that poor masticatory capacity could represent an early sign of elevated cardiovascular disease risk as evaluated by circulating markers of systemic inflammation and cardiomyocyte stress or damage. Approach and Results: In this cross-sectional analysis of the Paris Prospective Study III, a community-based observational study, 4837 adults aged 50 to 75 without cardiovascular disease history underwent a full-mouth clinical examination and plasma NTproBNP (N-terminal natriuretic propeptide), hs-CRP (high-sensitivity C-reactive protein), IL-6 (interleukin-6), hs-TNI (high-sensitivity troponin I) were measured using highly sensitive technics. Poor masticatory capacity was defined as <5 functional masticatory units, that is, pairs of opposing natural or prosthetically replaced posterior teeth. In linear regression analysis accounting for sociodemographic factors, cardiovascular disease risk factors, gingival inflammation, and body mass index, poor masticatory capacity was significantly associated with lower levels of NTproBNP (β=−0.11, P =0.045). The significant association between poor masticatory capacity and higher IL-6 in multivariable analysis was confounded by body mass index. There was no association between functional masticatory units and hs-TNI even in unadjusted analysis. Conclusions: The present findings support a nutritional pathway whereby diet alterations and the resulting abdominal obesity associated with poor masticatory capacity may contribute to the higher level of IL-6 and to the lower level of NTproBNP, respectively.

Background In recognition of the risk factors common between oral diseases and various chronic conditions and the intersection between oral health and some sustainable development goals, the current cross-sectional study was designed to quantify the burden of dental caries and identify factors associated with its occurrence in permanent teeth. Methods Using data from Egypt's population-based survey (2013–2014), two individual-level outcomes; past caries experience (DMFT > 0) and presence of untreated carious lesions (DT > 0) were assessed using the WHO basic methods for oral health surveys. Information on potential explanatory variables including sociodemographic characteristics, exposure to fluoridated water, dental attendance, and dental anxiety was gathered using a structured questionnaire. Stratified multistage cluster random sampling was used to recruit survey participants. Multivariable logistic regression was performed to identify significant potential risk factors for caries in the permanent dentition of Egyptians. Findings A total of 9,457 participants were included of which 70.3% had at least one untreated carious lesion. After adjusting for all covariates, analphabetic Egyptians were found to have significantly higher odds of caries experience in permanent dentition DMFT > 0 (OR 1.54, 95% CI [1.20–1.98]), DT > 0 (OR 1.62, 95% CI [1.32–2.00]). Males, however, had significantly lower caries risk DMFT > 0 (OR 0.75, 95% CI [0.67–0.85]), DT > 0 (OR 0.81, 95% CI [0.73–0.89]) when compared to females. Regarding age, mean DMFT scores were significantly lower in age groups (6–15 years) (OR 0.03, 95% CI [0.014; 0.082]), (16– 20 years) (OR 0.09, 95% CI [0.037; 0.23]), and (21–35 years) (OR 0.22, 95% CI [0.09; 0.53]) than among people ≥ 60 years. Conclusion Addressing individual-level caries risk factors should be complemented by addressing upstream factors to reduce burden of untreated dental caries among Egyptians.