title: Dental infections and serum inflammatory markers in patients with and without severe heart disease.
abstract: OBJECTIVE
  The objective of this study was to investigate if patients with severe heart disease (CHD patients) present more signs of dental infections than patients without heart disease (non-CHD patients), if serum inflammatory markers differ between the groups, and if there is a link between these and the oral health parameters.
  
  
  METHODS
  We performed clinical and radiologic dental examinations and collected serum samples of 256 patients with New York Heart Association class II-IV heart disease (CHD patients) and 250 non-CHD controls. Serum samples were analysed using pertinent methods in the clinical laboratory of the hospital, and the differences in serum biomarkers between CHD patients and non-CHD patients were examined using various statistical methods. A modified dental index (MDI) was constructed and used in the analyses.
  
  
  RESULTS
  CHD patients were significantly more likely to be edentulous (34.8% vs. 14.8%) and retain less natural teeth than non-CHD patients (8.6 vs. 17) (P <.001). In CHD patients the remaining teeth and supporting tissues were more often diseased. High MDI scores were significantly associated with CHD status (OR 1.31, CI 1.16-1.48), as was gingivitis (OR 3.37, CI 1.66-6.86), while the presence of deep periodontal pockets was not. Serum C-reactive protein and fibrinogen concentrations and blood erythrocyte sedimentation rates were higher in the CHD group. Also, H. pylori and Chlamydia antibodies were significantly higher in the CHD group.
  
  
  CONCLUSIONS
  CHD patients presented with poorer oral health status than non-CHD patients. Serum inflammatory markers were significantly higher in the CHD patients compared to the non-CHD group. High MDI scores linked with risk of CHD.
authors.affiliation: Institute of Dentistry, University of Helsinki, Finland. Jukka.Meurman@Helsinki.Fi
authors.forename: Jukka H
authors.initials: JH
authors.lastname: Meurman
authors.forename: Sok-Ja
authors.initials: SJ
authors.lastname: Janket
authors.forename: Markku
authors.initials: M
authors.lastname: Qvarnström
authors.forename: Pekka
authors.initials: P
authors.lastname: Nuutinen
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D002689:Chlamydia / Q000276:immunology; D016001:Confidence Intervals; D003327:Coronary Disease / Q000097:blood / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005891:Gingivitis / Q000150:complications; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009066:Mouth, Edentulous / Q000150:complications; D016017:Odds Ratio; D010510:Periodontal Diseases / Q000097:blood / Q000150:complications*; D010514:Periodontal Pocket / Q000150:complications; D014076:Tooth Diseases / Q000097:blood / Q000150:complications*
chemical_list: D000907:Antibodies, Bacterial; D015415:Biomarkers; D018836:Inflammation Mediators; D005340:Fibrinogen; D002097:C-Reactive Protein