Tooth Loss Doubles Risk of Death in Heart Disease Patients

A new study shows that tooth loss is linearly associated with increasing rates of death and stroke in coronary heart disease (CHD) patients.

Researchers at Uppsala University (Sweden), Duke University Medical Center (Durham, NC, USA), and other institutions examined 15,456 patients from 39 countries with stable CHD, which included prior myocardial infarction (MI), prior revascularization, or multi-vessel CHD. Patients reported the number of remaining teeth at baseline, and were then followed for an average 3.7 years. During follow up, there were 1,543 major cardiovascular events, 705 cardiovascular deaths, 1,120 deaths from any cause, and 301 strokes.

The researchers then investigated possible associations between self-reported tooth loss and cardiovascular outcomes, as adjusted for cardiovascular risk factors and socioeconomic status. The number of remaining teeth were divided into five categories (26-32 [considered all teeth], 20-25, 15-19, 1-14, and none). The patients with a high level of tooth loss were older, smokers, female, and less active and more likely to have diabetes, higher blood pressure, higher body mass index (BMI), and lower education.

The researchers found that compared to those with all of their teeth, the group with no teeth had a 27% increased risk of major cardiovascular events, 85% increased risk of cardiovascular death, 81% increased risk of all-cause death, and a 67% increased risk of stroke. The outcome risk increase was linear, rising at about 6% per tooth loss category, with the highest risk in those with no remaining teeth. The study was published on December 17, 2105, in the European Journal of Preventive Cardiology.

“This was an observational study, so we cannot conclude that gum disease directly causes adverse events in heart patients. But tooth loss could be an easy and inexpensive way to identify patients at higher risk who need more intense prevention efforts,” said lead author cardiologist Ola Vedin, MD, of Uppsala University Hospital. “While we can’t yet advise patients to look after their teeth to lower their cardiovascular risk, the positive effects of brushing and flossing are well established. The potential for additional positive effects on cardiovascular health would be a bonus.”

A statement released by the American Heart Association (AHA; Dallas, TX, USA) in 2012 states that healthy gums have not been proven to prevent atherosclerotic vascular disease (ASVD), nor will treating periodontal disease (PD) clearly reduce risk of heart attack or stroke. The statement was issued to address concerns about possible links between PD and ASVD, since the two disorders share several common risk factors, including smoking and diabetes mellitus (DM), which could also be independently linked to tooth loss.

Related Links:
Uppsala University
Duke University Medical Center