title: Removable dental prostheses and cardiovascular survival: a 15-year follow-up study.
abstract: OBJECTIVE
  In previous studies, increasing number of teeth predicted better survival and the acute needs for dental treatment predicted mortality. We sought to investigate whether restored dentitions by various removable dental prostheses impact cardiovascular (CVD) longevity.
  
  
  METHODS
  Kuopio Oral Health and Heart study was initiated as a cross-sectional investigation with 256 subjects with diagnosed coronary artery disease [CAD] and 250 age- and sex-matched controls without CAD in 1995-1996. The mean age of both groups was 61, 30% were females. We appended mortality follow-up records to the baseline data and formulated this 15-year follow-up study. We examined the relationship between various types of dental prostheses and cardiovascular mortality by proportional hazard regression analyses. We also explored their correlation to oral and systemic inflammatory markers such as asymptotic dental score and C-reactive protein.
  
  
  RESULTS
  In a model adjusted for age, sex and smoking, groups having only natural teeth (NT), removable partial denture(s) [PD] and NT, a PD and a full denture [FD], and FD/FD or FD/NT demonstrated the following hazard ratios for mortality (95% confidence interval). NT both arches: 1.00 [reference]; PD and NT: 0.75 [0.22-2.56]; PD and FD: 1.99 [1.05-3.81]; and FD opposed by FD or NT: 1.71 [0.93-3.13], respectively [p for trend=0.05]. Although statistically not significant, those with PD and NT with mean a number of teeth [Nteeth] of 15.4 had better survival compared with those who had all NT [Nteeth=22.5]; while those who had FD and PD [Nteeth=6.5] had shorter longevity than those with FD/FD or FD/NT [Nteeth=3.5].
  
  
  CONCLUSIONS
  Although not all subgroups of dental prostheses reached significant relationship with CVD mortality, our study suggests that not only the number [quantity] of remaining teeth but their maintenance [quality] removing potential inflammatory foci, such as pericoronitis or retained root tips, may positively impact on cardiovascular survival.
authors.affiliation: Boston University, Henry M. Goldman School of Dental Medicine, Boston, MA, USA. skjanket@bu.edu
authors.forename: S J
authors.initials: SJ
authors.lastname: Janket
authors.forename: M
authors.initials: M
authors.lastname: Surakka
authors.forename: J A
authors.initials: JA
authors.lastname: Jones
authors.forename: A
authors.initials: A
authors.lastname: Lam
authors.forename: R A
authors.initials: RA
authors.lastname: Schnell
authors.forename: L M
authors.initials: LM
authors.lastname: Rose
authors.forename: A W G
authors.initials: AW
authors.lastname: Walls
authors.forename: J H
authors.initials: JH
authors.lastname: Meurman
mesh_terms: D000367:Age Factors; D002097:C-Reactive Protein / Q000032:analysis; D002180:Candidiasis, Oral / Q000453:epidemiology; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000401:mortality*; D003430:Cross-Sectional Studies; D003728:Dental Calculus / Q000453:epidemiology; D003817:Dentition; D003824:Denture, Complete / Q000706:statistics & numerical data*; D003832:Denture, Partial, Removable / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D018836:Inflammation Mediators / Q000032:analysis; D008136:Longevity; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000453:epidemiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D013290:Streptococcal Infections / Q000453:epidemiology
chemical_list: D018836:Inflammation Mediators; D002097:C-Reactive Protein
keywords: Cardiovascular mortality; Dental prostheses; Inflammation; Number of teeth; Oral care