Poor dental health associated with cardiovascular disorders
Gum disease is associated with cardiovascular disorders and gives patients with known cardiovascular disorders a worse prognosis. This is the verdict of the largest study so far done in this field which is the subject of a thesis to be presented at Uppsala University tomorrow 9 October.
The thesis is based upon data from almost 16 000 patients from 39 countries, all of whom had known cardiovascular disorders. This means that they had either: i) had a previous heart attack, ii) undergone percutaneous coronary intervention (coronary angioplasty) or a bypass operation, or iii) had known narrowing of the coronary arteries.
At the start of the study, the patients reported the number of teeth they still had. Around 40 percent of the patients had fewer than 15 teeth, which is about half the number for a person with good dental health. The fewer teeth the patients in the study had, the greater the number of cardiovascular risk factors they had, such as diabetes, a smoking habit, obesity, raised cholesterol levels and signs of more frequent inflammation. The patients were monitored for around 4 years and at the end of the study the conclusion could be drawn that more gum disease led to a clearly worsened prognosis.
‘The patients with the greatest risk of episodes such as cardiovascular fatality or a stroke were the ones with no teeth at all but the risks increased successively starting with those who only had a few teeth missing,’ says Ola Vedin, the author of the study.
The fatality risk was almost double for the group with no teeth at all compared to those with a normal number of teeth. The increased risk of death and a stroke remained even if the figures were corrected using a number of traditional risk factors, socio-economic factors and so-called cardiovascular biomarkers. On the other hand, the association with heart attacks disappeared after correcting for these factors.
In summary, the findings made by the study indicate a broad, strong connection between dental health and cardiovascular risk factors and the prognosis for patients with cardiovascular disorders. The results also indicate that patients with gum disease have a higher risk of suffering cardiovascular episodes than can be predicted by traditional risk factors. This may be of importance when devising future preventive treatments.
‘One question the study doesn’t answer is whether there is any connection with the cause. Intervention studies will be needed to find an answer to that question,’ Ola Vedin says.