Tooth Loss Associated with Risk Factors for Coronary Heart Disease

Dr Ola Vedin University of Uppsala, Interview with:
Dr Ola Vedin
University of Uppsala, Sweden What are the main findings of the study?

Dr. Vedin: That self-reported tooth loss as a marker of periodontal disease is common in patients with established coronary heart disease and is associated with higher levels of LDL cholesterol, glucose levels, systolic blood pressure and waist circumference as well as diabetes and smoking, i.e. risk factors for coronary heart disease. Gum bleeding, another marker of periodontal disease, was associated with higher levels of LDL cholesterol and systolic blood pressure. In summary, patients with few remaining teeth and gum bleeding demonstrated a heavier burden of cardiovascular risk factors. Were any of the findings unexpected?

Dr. Vedin: That as many as 40% of all patients had fewer than 15 remaining teeth, roughly corresponding to less than half of their teeth left. There were substantial differences in prevalence between geographic regions but more surprising were the differences in prevalence seen between countries even within the same region. We were also surprised by the association between tooth loss and such a wide spectrum of cardiovascular risk factors. What should clinicians and patients take away from your report?

Dr. Vedin: Our report shows that self-reported periodontal disease and more specifically, self-reported tooth loss and gum bleeding are linked to several cardiovascular risk factors in patients who have coronary heart disease. This could support the possibility that periodontal disease and coronary heart disease are two associated conditions. However, our results cannot determine whether an independent association between periodontal disease and coronary heart disease exists. Therefore, judging by these results, we cannot, for instance, advocate periodontal therapy as a means to reduce coronary heart disease. In order to determine this, further studies are needed. What recommendations do you have for future research as a result of this study?

Dr. Vedin: The next step for us will be very important and is currently being planned, namely to determine whether these associations also translate into adverse cardiovascular outcomes for the patients. Outside of our planned analyses, this scientific field would also really benefit from an intervention study, i.e to determine whether periodontal treatment reduces cardiovascular events. That would truly answer the question of causality between the conditions but such a study would face substantial challenges for many reasons.


Periodontal disease in patients with chronic coronary heart disease: Prevalence and association with cardiovascular risk factors

Should dental health now be considered a marker of coronary heart disease?

Presented April 10 2014 at
European Journal of Preventive Cardiology.