title: Dental prophylaxis decreases the risk of acute myocardial infarction: a nationwide population-based study in Taiwan.
abstract: OBJECTIVE
  To investigate the association between periodontal disease (PD) and acute myocardial infarction (AMI), and evaluate the effect of dental prophylaxis on the incidence rate (IR) of AMI.
  
  
  METHODS
  The Longitudinal Health Insurance Database 2000 from the National Health Insurance program was used to identify 511,630 patients with PD and 208,713 without PD during 2000-2010. Subjects with PD were grouped according to treatment (dental prophylaxis, intensive treatment, and PD without treatment). The IRs of AMI during the 10-year follow-up period were compared among groups. Cox regression analysis adjusted for age, sex, socioeconomic status, residential urbanicity, and comorbidities was used to evaluate the effect of PD treatment on the incidence of AMI.
  
  
  RESULTS
  The IR of AMI among subjects without PD was 0.19%/year. Among those with PD, the IR of AMI was lowest in the dental prophylaxis group (0.11%/year), followed by the intensive treatment (0.28%/year) and PD without treatment (0.31%/year; P<0.001) groups. Cox regression showed that the hazard ratio (HR) for AMI was significantly lower in the dental prophylaxis group (HR =0.90, 95% confidence interval =0.86-0.95) and higher in the intensive treatment (HR =1.09, 95% confidence interval =1.03-1.15) and PD without treatment (HR =1.23, 95% confidence interval =1.13-1.35) groups than in subjects without PD.
  
  
  CONCLUSIONS
  PD is associated with a higher risk of AMI, which can be reduced by dental prophylaxis to maintain periodontal health.
authors.affiliation: Department of Dentistry, Taipei City Hospital, Taipei, Taiwan ; Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Ya-Ling
authors.initials: YL
authors.lastname: Lee
authors.affiliation: Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan ; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
authors.forename: Hsiao-Yun
authors.initials: HY
authors.lastname: Hu
authors.affiliation: Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Pesus
authors.initials: P
authors.lastname: Chou
authors.affiliation: Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan ; Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan ; Department of Neurosurgery, Taipei City Hospital, Taipei, Taiwan.
authors.forename: Dachen
authors.initials: D
authors.lastname: Chu
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003777:Dental Prophylaxis / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology; D010510:Periodontal Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology
keywords: acute myocardial infarction; dental prophylaxis; dental scaling; periodontal disease