Relationship of periodontal disease and tooth loss to prevalence of coronary heart disease.
BACKGROUND
Studies relating periodontal disease to coronary heart disease (CHD) have provided equivocal results using tooth loss and/or clinical signs of periodontal disease as measures of periodontal exposure.


METHODS
The purpose of this cross-sectional study was to evaluate the relationship of tooth loss and periodontitis to prevalent CHD at the Atherosclerosis Risk in Communities (ARIC) visit 4 using both tooth loss and clinical signs of disease in a population-based sample of 8,363 men and women aged 52 to 75 years from four U.S. communities. Each subject participated in a complete periodontal examination, assessment of missing teeth, assessment of prevalent CHD, and a number of laboratory tests and questionnaires. High attachment loss was defined as > or = 10% of sites with attachment loss > 3 mm and high tooth loss was defined as fewer than 17 remaining teeth.


RESULTS
Individuals with both high attachment loss and high tooth loss (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1 to 2.0) and edentulous individuals (OR 1.8, CI 1.4 to 2.4) had elevated odds of prevalent CHD compared to individuals with low attachment loss and low tooth loss, while controlling for a number of traditional risk factors for CHD.


CONCLUSIONS
These results suggest that tooth loss and periodontal disease are associated with prevalent CHD, but only when both are present. The weaker relationships between periodontal disease and CHD that have been found among older adults may be due to older adults having fewer teeth. Future longitudinal studies should be designed to ascertain the cause of tooth loss during follow-up.
Center for Oral and Systemic Diseases, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7450, USA. john_elter@unc.edu
John R
JR
Elter
Catherine M E
CM
Champagne
Steven
S
Offenbacher
James D
JD
Beck
D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D003327:Coronary Disease / Q000150:complications / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D008922:Mississippi / Q000453:epidemiology; D009066:Mouth, Edentulous / Q000150:complications / Q000453:epidemiology; D009657:North Carolina / Q000453:epidemiology; D016017:Odds Ratio; D017622:Periodontal Attachment Loss / Q000150:complications / Q000453:epidemiology; D010510:Periodontal Diseases / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D016388:Tooth Loss / Q000150:complications / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data