title: Oral infection, regular alcohol drinking pattern, and myocardial infarction.
abstract: Oral infections have been associated with an increased risk for myocardial infarction (MI) and other cardiovascular diseases (CVD). Conversely, low, regular alcohol consumption is associated with a lower association of CVD. The objective was to test the novel hypothesis that oral infections are modified by regular alcohol drinking which has the effect of lowering the incidence of MI's. The effect has been observed where tooth extractions where carried out due to infections and compared with extractions unconnected to infections. Oral infections and in particular periodontal infections impose an infectious load on the health in many people. In its advanced forms (periodontal pockets ≥ 6mm) periodontitis affects ∼10-15% of adults. The infection runs a chronic course with exacerbations. The bacteria cause local infection destructive to the supporting tissues of the teeth and have been detected in systemic diseases through bacterial products and bacteria entering the circulation. The often persistent, long term history of chronic periodontal infection in individuals is a challenge to the immune system. Over 700 oral bacteria and other microorganisms have been identified, many of which are virulent. Control of the level of oral microbiota is through well known oral hygiene measures. Alcohol by being bactericidal is a factor that may reduce the bacterial level in the oral cavity. If this effect truly exists, it should be observed through reduction of infections in the mouth. Tooth extraction is the ultimate consequence of periodontal and dental infections and a reduction of tooth extraction due to infections should therefore be observed. The hypothesis was tested using the screening data of the Oslo II-study in a cross sectional analysis. The Oslo-study included men aged 48-67 years. The main finding was that the effect of a drinking pattern of 2-7 times per week reduced the risk of MI among men who had a history of tooth extractions due to infections versus tooth extraction for other causes or no extractions. This hypothesis supports an explanation as to why oral infection is a weaker independent risk factor for CVD in some studies. It also gives an indication of the reason for an added benefit by a regular drinking pattern as part of the Mediterranean diet. The important consequence of this hypothesis is the added importance of optimal oral hygiene for the prevention of CVD as well as for the benefit of good oral health.
authors.affiliation: Department of Oral Biology, University of Oslo, Norway. a.l.haheim@odont.uio.no
authors.forename: Lise Lund
authors.initials: LL
authors.lastname: Håheim
authors.forename: Ingar
authors.initials: I
authors.lastname: Olsen
authors.forename: Kjersti S
authors.initials: KS
authors.lastname: Rønningen
mesh_terms: D000428:Alcohol Drinking; D015331:Cohort Studies; D006801:Humans; D008962:Models, Theoretical; D009059:Mouth Diseases / Q000150:complications* / Q000382:microbiology; D009203:Myocardial Infarction / Q000150:complications*