title: Common oral mucosal diseases, systemic inflammation, and cardiovascular diseases in a large cross-sectional US survey.
abstract: BACKGROUND
  Inflammation of the gingivae (periodontitis) has been associated with raised serum biomarkers of inflammation, sub-clinical markers of atherosclerosis, and increased risk of and/or mortality from cardiovascular disease (CVD). There remain little information regarding the association between other common oral inflammatory disease, systemic inflammation, and CVD. The objective of the study was to assess the association between common oral mucosal diseases, circulating markers of inflammation, and increased prevalence of CVD in a cross-sectional survey of a nationally representative sample of the noninstitutionalized civilians in the United States.
  
  
  METHODS
  Data for this study are from 17,223 men and women aged ≥ 17 years who received oral examination as part of the Third National Health and Nutrition Examination Survey. The primary and secondary outcome measures were the association of oral mucosal diseases with raised serum levels of C-reactive protein/fibrinogen and increased prevalence of CVD, respectively. Adjustment for common confounding factors was performed.
  
  
  RESULTS
  Having oral mucosal disease was associated with systemic inflammation (serum levels of C-reactive protein ≥ 10 mg/dL) (odds ratio 1.41, 95% CI 1.02-1.94). Individuals with oral mucosal disease were 1.36 times (95% CI 1.02-1.80) more likely to have history of myocardial infarction and 1.33 times (95% CI 1.03-1.71) more likely to report angina than unaffected individuals. All associations were independent of common confounding factors.
  
  
  CONCLUSIONS
  This is the first study to suggest that common oral mucosal diseases are independently associated with raised markers of systemic inflammation and history of CVD.
authors.affiliation: UCL Eastman Dental Institute, Oral Medicine, University College London, London, UK. s.fedele@eastman.ucl.ac.uk
authors.forename: Stefano
authors.initials: S
authors.lastname: Fedele
authors.forename: Wael
authors.initials: W
authors.lastname: Sabbah
authors.forename: Nikos
authors.initials: N
authors.lastname: Donos
authors.forename: Stephen
authors.initials: S
authors.lastname: Porter
authors.forename: Francesco
authors.initials: F
authors.lastname: D'Aiuto
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000150:complications* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007249:Inflammation / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000150:complications* / Q000453:epidemiology; D009061:Mouth Mucosa; D014481:United States