Volume 75, Issue 6 p. 782-790
75th Anniversary

Relationship of Periodontal Disease and Tooth Loss to Prevalence of Coronary Heart Disease

Dr. John R. Elter

Corresponding Author

Dr. John R. Elter

Center for Oral and Systemic Diseases and Comprehensive Center for Inflammatory Disorders, School of Dentistry, University of North Carolina, Chapel Hill, NC.

Correspondence: Dr. John R. Elter, Department of Dental Ecology, School of Dentistry, CB #7450, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450. Fax: 919/966-7537; e-mail: [email protected].Search for more papers by this author
Catherine M.E. Champagne

Catherine M.E. Champagne

Center for Oral and Systemic Diseases and Comprehensive Center for Inflammatory Disorders, School of Dentistry, University of North Carolina, Chapel Hill, NC.

Search for more papers by this author
Steven Offenbacher

Steven Offenbacher

Center for Oral and Systemic Diseases and Comprehensive Center for Inflammatory Disorders, School of Dentistry, University of North Carolina, Chapel Hill, NC.

Search for more papers by this author
James D. Beck

James D. Beck

Center for Oral and Systemic Diseases and Comprehensive Center for Inflammatory Disorders, School of Dentistry, University of North Carolina, Chapel Hill, NC.

Search for more papers by this author
First published: 01 June 2004
Citations: 101

Abstract

Background: Studies relating periodontal disease to coronary heart disease (CHD) have provided equivocal results using tooth loss and/or clinical signs of periodontal disease as measures of periodontal exposure.

Methods: The purpose of this cross-sectional study was to evaluate the relationship of tooth loss and periodontitis to prevalent CHD at the Atherosclerosis Risk in Communities (ARIC) visit 4 using both tooth loss and clinical signs of disease in a population-based sample of 8,363 men and women aged 52 to 75 years from four U.S. communities. Each subject participated in a complete periodontal examination, assessment of missing teeth, assessment of prevalent CHD, and a number of laboratory tests and questionnaires. High attachment loss was defined as ≥10% of sites with attachment loss >3 mm and high tooth loss was defined as fewer than 17 remaining teeth.

Results: Individuals with both high attachment loss and high tooth loss (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1 to 2.0) and edentulous individuals (OR 1.8, CI 1.4 to 2.4) had elevated odds of prevalent CHD compared to individuals with low attachment loss and low tooth loss, while controlling for a number of traditional risk factors for CHD.

Conclusions: These results suggest that tooth loss and periodontal disease are associated with prevalent CHD, but only when both are present. The weaker relationships between periodontal disease and CHD that have been found among older adults may be due to older adults having fewer teeth. Future longitudinal studies should be designed to ascertain the cause of tooth loss during follow-up. J Periodontol 2004;75:782-790.