Number of teeth as a predictor of cardiovascular mortality in a cohort of 7,674 subjects followed for 12 years.
BACKGROUND
That oral health is related to the development of different cardiovascular disorders is reported in a number of studies. This study investigates if different parameters of oral health are associated with future mortality in different cardiovascular disorders in a dose-dependent manner.


METHODS
A total of 7,674 subjects (3,300 males and 4,374 females; age range 20 to 89 years) received a dental examination by specialists in periodontology between the years 1976 and 2002. Number of remaining teeth, severity of periodontal disease, number of deepened periodontal pockets, and bleeding on probing were evaluated in relation to cause of death.


RESULTS
During a median follow-up period of 12 years, 629 of the subjects died. For 299 subjects the cause of mortality was cardiovascular disease (CVD); 167 of these subjects died from coronary heart disease (CHD); 83 died from stroke; and 49 died from aortic aneurysm or congestive heart failure. The causes of death for the remaining 330 subjects were other than CVD. After adjustment for age, gender, and smoking, number of remaining teeth predicted in a dose-dependent manner all-cause mortality and mortality in CVD and in CHD (P <0.0001 for all), but not mortality from stroke (P = 0.15). Cox regression analysis revealed a seven-fold increased risk for mortality from CHD in subjects with <10 teeth compared to those with >25 teeth. Severity of periodontal disease, number of deepened periodontal pockets, and bleeding on probing were not related to mortality in a dose-dependent manner after adjustment for confounders.


CONCLUSIONS
This fairly large, prospective study with a long follow-up period presents for the first time a dose-dependent relationship between number of teeth and both all-cause and CVD mortality, indicating a link between oral health and CVD, and that the number of teeth is a proper indicator for oral health in this respect.
Holmlund
Anders
A
Department of Periodontology, County Hospital of Gävle-Sandviken, 801 87 Gävle, Sweden. anders.holmlund@lg.se
Holm
Gunnar
G
Lind
Lars
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000150:complications* / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000150:complications* / Q000401:mortality*; D002423:Cause of Death; D003327:Coronary Disease / Q000150:complications / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D016016:Proportional Hazards Models; D011446:Prospective Studies; D020521:Stroke / Q000150:complications / Q000401:mortality; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D016388:Tooth Loss / Q000150:complications* / Q000453:epidemiology; D055815:Young Adult