title: Dental and periodontal status and risk for progression of carotid atherosclerosis: the inflammation and carotid artery risk for atherosclerosis study dental substudy.
abstract: OBJECTIVE
  Dental and periodontal disease are potentially involved in the pathogenesis of atherosclerosis. We investigated whether dental and periodontal status is associated with the presence and future progression of carotid stenosis.
  
  
  METHODS
  We randomly selected 411 of 1268 participants from the prospective Inflammation and Carotid Artery Risk for Atherosclerosis Study and evaluated dental and periodontal status and oral hygiene at baseline measuring three World Health Organization-validated indices: DMFT (decayed, missing, filled teeth), SLI (Silness-Löe Index), and CPITN (community periodontal index for treatment needs), respectively. The degree of carotid stenosis was measured by duplex ultrasound at baseline and after median 7.5 months (range=6 to 9 months) to identify patients with progressive carotid stenosis.
  
  
  RESULTS
  DMFT (P<0.01), SLI (P=0.048), CPITN (P=0.007), and edentulousness (P=0.007) were associated with the baseline degree of carotid stenosis. Atherosclerosis progression was observed in 48 of 411 patients (11.7%). DMFT (adjusted odds ratio [OR]=1.11, 95% CI=1.01 to 1.22, P=0.032) and SLI (adjusted OR=1.77, 95% CI=1.09 to 2.79, P=0.021), but not CPITN (adjusted OR=1.51, 95% CI=0.89 to 2.45, P=0.16) were significant predictors of disease progression, irrespective of traditional cardiovascular risk factors and the baseline degree of stenosis. Edentulous patients had a significantly increased risk for disease progression as compared with patients with teeth (adjusted OR=2.10, 95% CI=1.06 to 4.16, P=0.33).
  
  
  CONCLUSIONS
  Dental status, oral hygiene, and particularly tooth loss are associated with the degree of carotid stenosis and predict future progression of the disease.
authors.affiliation: Clinic of Dentistry, Medical University, Vienna, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schillinger
authors.forename: Wolf
authors.initials: W
authors.lastname: Kluger
authors.forename: Markus
authors.initials: M
authors.lastname: Exner
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Mlekusch
authors.forename: Schila
authors.initials: S
authors.lastname: Sabeti
authors.forename: Jasmin
authors.initials: J
authors.lastname: Amighi
authors.forename: Oswald
authors.initials: O
authors.lastname: Wagner
authors.forename: Erich
authors.initials: E
authors.lastname: Minar
authors.forename: Martin
authors.initials: M
authors.lastname: Schillinger
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D016893:Carotid Stenosis / Q000150:complications* / Q000000981:diagnostic imaging*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000378:metabolism; D002537:Intracranial Arteriosclerosis / Q000150:complications* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene; D010510:Periodontal Diseases / Q000150:complications*; D018570:Risk Assessment; D012307:Risk Factors; D014076:Tooth Diseases / Q000150:complications*; D016388:Tooth Loss / Q000150:complications; D014463:Ultrasonography
chemical_list: D002097:C-Reactive Protein