Oral Health Indicators Poorly Predict Coronary Heart Disease Deaths

Tuominen, Risto; Reunanen, Antti; Paunio, Mikko; Paunio, Ilkka; Aromaa, Arpo

doi:10.1177/154405910308200911

Cited by 101 publications

(122 citation statements)

References 29 publications

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“…5 Nevertheless, other studies failed to find this association. 17,26 The methodologies of previous studies testing the association between oral health and CVD differed from that of the present study. A cohort study 3 measured the mean bone loss and the probing pocket depth scores per tooth.…”

Section: Discussioncontrasting

confidence: 47%

“…Accordingly, there is some evidence that, after adjusting for these risk factors, the relationship between oral health and CVD may be weakened. 17 Self-reported health status assessing systemic diseases and health-related conditions are widely used in populational investigations. In the last years, self-reported oral health (SROH) status has been increasingly implemented in dentistry.…”

Section: Introductionmentioning

confidence: 99%

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

Gomes¹,

Chagas

Padilha³

et al. 2012

Braz. oral res.

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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 (< 20teeth 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.

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Section: Discussioncontrasting

confidence: 47%

Section: Introductionmentioning

confidence: 99%

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

Gomes¹,

Chagas

Padilha³

et al. 2012

Braz. oral res.

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“…19 -21 A third is confounding variables such as smoking or diabetes mellitus that largely affect both tooth loss and vascular diseases may produce spurious association between 2 phenomena. [22][23][24][25] Tooth loss might lead to dietary pattern change, resulting in an increased risk of hypertension because the change of dietary pattern may be associated with hypertension. 26 Systolic and diastolic blood pressure are important predictors for cardiovascular disease and stroke in the United States and Europe as well as in eastern Asia.…”

mentioning

confidence: 99%

Tooth Loss Is Associated With an Increased Risk of Hypertension in Postmenopausal Women

et al. 2004

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Abstract-Tooth loss has been associated with an increased risk of vascular diseases such as coronary heart disease and cerebrovascular disease. Little is known whether hypertension is an important factor linking 2 phenomena in postmenopausal women. We compared an incidence of hypertension and traditional risk factors for vascular diseases between 2 age-matched groups: 67 postmenopausal women with missing teeth and 31 without missing teeth. In addition to blood pressure, serum concentration of total cholesterol, high-and low-density lipoprotein cholesterol and triglycerides, plasma angiotensin-converting enzyme activity, plasma angiotensin II concentration, plasma renin activity, and resting heart rate were measured as traditional risk factors for vascular diseases. Subjects without missing teeth had significantly lower diastolic blood pressure than did subjects with missing teeth (Pϭ0.021). The former tended to have lower systolic blood pressure than did the latter (Pϭ0.058). There were no significant differences in other variables between subjects with and without missing teeth. The odds ratio of having hypertension in subjects with missing teeth was 3.59 (95% confidence interval, 1.10 to 11.7) after adjustment of obesity, hypercholesterolemia, and hypertriglyceridemia. Our results suggest that hypertension may be an important factor linking tooth loss and an increased risk of vascular diseases in postmenopausal women.

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“…These were based on thresholds of either mean CAL (Andriankaja et al 2007, Dorn et al 2010, extent scores based on CAL (Cueto et al 2005), mean bone loss scores according to Schei (Mendez et al 1998) or based on a minimum number of teeth exhibiting CAL (Sim et al 2008) or PD (Ajwani et al 2003b) above a certain threshold (Table 2). Furthermore, studies used either continuous measures of PPD or CAL (Lopez et al 2002, Dietrich et al 2008, Jimenez et al 2009, Dorn et al 2010, or generated multiple exposure categories based on mean bone loss scores (Dietrich et al 2008, Jimenez et al 2009), extent of CAL (Sim et al 2008), mean of CAL or number of teeth exhibiting CAL and/ or PD above a certain threshold (Tuominen et al 2003, Xu & Lu 2011.…”

Section: Exposure Measurements and Operationalizationmentioning

confidence: 99%

“…Potentially pertinent studies received from electronic search Three of the cohort studies (Ajwani et al 2003b, Tuominen et al 2003, Xu & Lu 2011 were exclusively on cardiovascular mortality assessed based on linkage of periodontal baseline data with death registry data. All case-control studies were restricted to non-fatal ACVD.…”

Section: Types Of Outcomes and Studiesmentioning

confidence: 99%

The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease

Dietrich

Sharma

Walter

et al. 2013

Journal of Periodontology

182

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The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease. AbstractObjectives: The objective of this study was to systematically review the epidemiological evidence for an association between periodontitis (PD) and incident atherosclerotic cardiovascular disease (ACVD), including coronary heart disease (CHD), cerebrovascular disease and peripheral arterial disease. Methods: Systematic review of cohort and case-control studies on the association of clinically or radiographically diagnosed PD and ACVD. Results: Overall, 12 studies were included in this study (six studies on CHD, three studies on cerebrovascular disease, two studies on both coronary heart and cerebrovascular disease mortality and one study on peripheral arterial disease). All but one study reported positive associations between various periodontal disease measures and the incidence of ACVD, at least in specific subgroups. The association was stronger in younger adults and there was no evidence for an association between PD and incident CHD in subjects older than 65 years. Only one study evaluated the association between PD and secondary cardiovascular events. Conclusions: There is evidence for an increased risk of ACVD in patients with PD compared to patients without. However, this may not apply to all groups of the population. There is insufficient evidence for an association between PD and the incidence of secondary cardiovascular events. The possible association between periodontitis (PD) and atherosclerotic cardiovascular disease (ACVD) has received much attention over the past two decades, and a significant number of epidemiological studies have been conducted during this time. The evidence has been systematically reviewed several times during that period (Hujoel 2002, Janket et al. 2003, Khader et al. 2004, Bahekar et al. 2007, Humphrey et al. 2008, Blaizot et al. 2009). Most recently, a comprehensive review was performed by an American Heart Association (AHA) working group (Lockhart et al. 2012), which concluded that "periodontal disease is associated with atherosclerotic Conflict of interest and source of funding statementThe authors declare no conflict of interest. The workshop was funded by an unrestricted educational grant from Colgate-Palmolive to the European Federation of Periodontology and the American Academy of Periodontology.© 2013 European Federation of Periodontology and American Academy of Periodontology S70 vascular disease independent of known confounders". It further concluded that there was no evidence for a causal link and that, therefore, "statements that imply a causative association between periodontal disease and specific atherosclerotic vascular disease events […] are unwarranted". The review further highlighted several research gaps and methodological issues relevant to further research, including the need for uniform criteria for PD measures and case definitions but mainly with regard to the need of well-designed controlled interventional studies w...

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Oral Health Indicators Poorly Predict Coronary Heart Disease Deaths

Cited by 101 publications

References 29 publications

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

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

Tooth Loss Is Associated With an Increased Risk of Hypertension in Postmenopausal Women

The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease

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