title: The association of tooth scaling and decreased cardiovascular disease: a nationwide population-based study.
abstract: OBJECTIVE
  Poor oral hygiene has been associated with an increased risk for cardiovascular disease. However, the association between preventive dentistry and cardiovascular risk reduction has remained undetermined. The aim of this study is to investigate the association between tooth scaling and the risk of cardiovascular events by using a nationwide, population-based study and a prospective cohort design.
  
  
  METHODS
  Our analyses were conducted using information from a random sample of 1 million persons enrolled in the nationally representative Taiwan National Health Insurance Research Database. Exposed individuals consisted of all subjects who were aged ≥ 50 years and who received at least 1 tooth scaling in 2000. The comparison group of non-exposed persons consisted of persons who did not undergo tooth scaling and were matched to exposed individuals using propensity score matching by the time of enrollment, age, gender, history of coronary artery disease, diabetes, hypertension, and hyperlipidemia.
  
  
  RESULTS
  During an average follow-up period of 7 years, 10,887 subjects who had ever received tooth scaling (exposed group) and 10,989 age-, gender-, and comorbidity-matched subjects who had not received tooth scaling (non-exposed group) were enrolled. The exposed group had a lower incidence of acute myocardial infarction (1.6% vs 2.2%, P<.001), stroke (8.9% vs 10%, P=.03), and total cardiovascular events (10% vs 11.6%, P<.001) when compared with the non-exposed group. After multivariate analysis, tooth scaling was an independent factor associated with less risk of developing future myocardial infarction (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.57-0.85), stroke (HR, 0.85; 95% CI, 0.78-0.93), and total cardiovascular events (HR, 0.84; 95% CI, 0.77-0.91). Furthermore, when compared with the non-exposed group, increasing frequency of tooth scaling correlated with a higher risk reduction of acute myocardial infarction, stroke, and total cardiovascular events (P for trend<.001).
  
  
  CONCLUSIONS
  Tooth scaling was associated with a decreased risk for future cardiovascular events.
authors.affiliation: Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Zu-Yin
authors.initials: ZY
authors.lastname: Chen
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Chiang
authors.forename: Chin-Chou
authors.initials: CC
authors.lastname: Huang
authors.forename: Chia-Min
authors.initials: CM
authors.lastname: Chung
authors.forename: Wan-Leong
authors.initials: WL
authors.lastname: Chan
authors.forename: Po-Hsun
authors.initials: PH
authors.lastname: Huang
authors.forename: Shing-Jong
authors.initials: SJ
authors.lastname: Lin
authors.forename: Jaw-Wen
authors.initials: JW
authors.lastname: Chen
authors.forename: Hsin-Bang
authors.initials: HB
authors.lastname: Leu
mesh_terms: D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control*; D015897:Comorbidity; D003729:Dental Care / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000517:prevention & control; D016017:Odds Ratio; D009910:Oral Hygiene; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012107:Research Design; D020521:Stroke / Q000453:epidemiology / Q000517:prevention & control; D013624:Taiwan / Q000453:epidemiology; D014070:Tooth