Total tooth loss and prevalent cardiovascular disease in men and women: possible roles of citrus fruit consumption, vitamin C, and inflammatory and thrombotic variables.
OBJECTIVE
Tooth loss has been associated with cardiovascular disease (CVD), but the mechanisms are unclear. We evaluated the association of total tooth loss with prevalent CVD in men and women; as well as with citrus fruit consumption, plasma vitamin C, and inflammatory and thrombotic variables.


METHODS
We used an age-and sex-stratified population survey, of men and women aged 25-74 years, in North Glasgow.


RESULTS
Thirty-eight percent of women and 29% of men were edentulous. Total tooth loss was associated with prevalent CVD in both sexes. After adjustment for major potential confounders (age, sex, smoking, and social class), the odds ratio (95% CI) for prevalent CVD was 1.55 (1.13, 2.13) in the edentulous. Total tooth loss was also associated with low citrus fruit consumption and low plasma vitamin C levels, increased plasma C-reactive protein in men, and with increased plasma interleukin-6, fibrinogen, and factor VIII levels in women.


CONCLUSIONS
Prevalent CVD is associated with total tooth loss. Possible mechanisms include low intake of citrus fruit, and hence, low plasma vitamin C levels, and a predisposition to low-grade inflammation and thrombosis. It may be prudent to ensure adequate vitamin C intake in people with no teeth.
Lowe
Gordon
G
University Department of Medicine, Royal Infirmary, 10 Alexandra Parade, Glasgow, G31 2ER, UK. gdl1j@clinmed.gla.ac.uk
Woodward
Mark
M
Rumley
Ann
A
Morrison
Caroline
C
Tunstall-Pedoe
Hugh
H
Stephen
Kenneth
K
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001205:Ascorbic Acid / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D002957:Citrus; D004032:Diet / Q000009:adverse effects*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009066:Mouth, Edentulous / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D017678:Sex Distribution; D016388:Tooth Loss / Q000097:blood / Q000150:complications / Q000453:epidemiology
D001205:Ascorbic Acid