Dental disease and risk of coronary heart disease and mortality.
OBJECTIVE
To investigate a reported association between dental disease and risk of coronary heart disease.


METHODS
National sample of American adults who participated in a health examination survey in the early 1970s.


METHODS
Prospective cohort study in which participants underwent a standard dental examination at baseline and were followed up to 1987. Proportional hazards analysis was used to estimate relative risks adjusted for several covariates.


METHODS
Incidence of mortality or admission to hospital because of coronary heart disease; total mortality.


RESULTS
Among all 9760 subjects included in the analysis those with periodontitis had a 25% increased risk of coronary heart disease relative to those with minimal periodontal disease. Poor oral hygiene, determined by the extent of dental debris and calculus, was also associated with an increased incidence of coronary heart disease. In men younger than 50 years at baseline periodontal disease was a stronger risk factor for coronary heart disease; men with periodontitis had a relative risk of 1.72. Both periodontal disease and poor oral hygiene showed stronger associations with total mortality than with coronary heart disease.


CONCLUSIONS
Dental disease is associated with an increased risk of coronary heart disease, particularly in young men. Whether this is a causal association is unclear. Dental health may be a more general indicator of personal hygiene and possibly health care practices.
DeStefano
F
F
Department of Epidemiology and Biostatistics, Marshfield Medical Research Foundation, WI 54449-5790.
Anda
R F
RF
Kahn
H S
HS
Williamson
D F
DF
Russell
C M
CM
D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D003728:Dental Calculus / Q000150:complications; D003731:Dental Caries / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene; D009911:Oral Hygiene Index; D010510:Periodontal Diseases / Q000150:complications* / Q000453:epidemiology; D010512:Periodontal Index; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014481:United States / Q000453:epidemiology