title: Total tooth loss and prevalent cardiovascular disease in men and women: possible roles of citrus fruit consumption, vitamin C, and inflammatory and thrombotic variables.
abstract: 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.
authors.affiliation: University Department of Medicine, Royal Infirmary, 10 Alexandra Parade, Glasgow, G31 2ER, UK. gdl1j@clinmed.gla.ac.uk
authors.forename: Gordon
authors.initials: G
authors.lastname: Lowe
authors.forename: Mark
authors.initials: M
authors.lastname: Woodward
authors.forename: Ann
authors.initials: A
authors.lastname: Rumley
authors.forename: Caroline
authors.initials: C
authors.lastname: Morrison
authors.forename: Hugh
authors.initials: H
authors.lastname: Tunstall-Pedoe
authors.forename: Kenneth
authors.initials: K
authors.lastname: Stephen
mesh_terms: 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
chemical_list: D001205:Ascorbic Acid