title: Number of teeth, C-reactive protein, fibrinogen and cardiovascular mortality: a 15-year follow-up study in a Finnish cohort.
abstract: OBJECTIVE
  To test whether the number of teeth, an inverse proxy for composite oral infection scores is associated with better survival.
  
  
  METHODS
  The Kuopio Oral Health and Heart study initiated a case-control study in 1995-1996 consisting of 256 consecutive coronary artery disease patients and 250 age and gender-matched controls. We appended the mortality data and formulated a longitudinal study. By May 31st, 2011, 124 mortalities had occurred and 80 of which were of cardiovascular origin. Using Cox proportional hazards models, we assessed the association of the teeth group (Teethgrp) - consisting of 10 teeth - with cardiovascular and all-cause mortality after 15.8 years of median follow-up.
  
  
  RESULTS
  In multivariate models, with the edentulous state as reference, one level increase in Teethgrp was associated with significantly increased survival from cardiovascular disease (CVD) mortality with a Hazard Ratio (HR) 0.73, p-value = 0.02 but not with all-cause mortality (HR = 0.87, p = 0.13). The findings were not mediated by C-reactive protein (CRP) levels ≥3 mg/L or by median fibrinogen levels, but were mediated by CRP levels >5 mg/L.
  
  
  CONCLUSIONS
  Each increment of 10 teeth from the edentulous state was associated with a 27% improved CVD survival, independent of low-grade systemic inflammation.
authors.affiliation: Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA.
authors.forename: Sok-Ja
authors.initials: SJ
authors.lastname: Janket
authors.forename: Alison E
authors.initials: AE
authors.lastname: Baird
authors.forename: Judith A
authors.initials: JA
authors.lastname: Jones
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Jackson
authors.forename: Markku
authors.initials: M
authors.lastname: Surakka
authors.forename: Wen
authors.initials: W
authors.lastname: Tao
authors.forename: Jukka H
authors.initials: JH
authors.lastname: Meurman
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Van Dyke
mesh_terms: D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000401:mortality*; D003728:Dental Calculus / Q000453:epidemiology; D003731:Dental Caries / Q000453:epidemiology; D003817:Dentition; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008074:Lipoproteins / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009066:Mouth, Edentulous / Q000453:epidemiology; D010483:Periapical Diseases / Q000453:epidemiology; D010497:Pericoronitis / Q000453:epidemiology; D010510:Periodontal Diseases / Q000453:epidemiology; D011446:Prospective Studies; D012907:Smoking / Q000453:epidemiology
chemical_list: D008074:Lipoproteins; D005340:Fibrinogen; D002097:C-Reactive Protein
keywords: C-reactive protein; CVD mortality; fibrinogen; mediation analyses; number of teeth