PoorOralHealth andCoronary HeartDisease

A fewrecent studies haveshownassociations between poororal health andcoronary heart disease (CHD). Theobjective ofthis study wastoexamine theincidence of CHD inrelation tonumberofteeth present andperiodontal disease, andtoexplorepotential mediators ofthis association, inaprospective cohort study. Thisstudyisa partoftheongoing Health Professionals Follow-Up Study (HPFS). Participants included aUS national sampleof 44,119malehealth professionals (58%ofwhom were dentists), from40to75yearsofage,whoreported no diagnosed CHD,cancer, ordiabetes atbaseline. We recorded 757incident casesofCHD,including fatal and non-fatal myocardial infarction andsuddendeath, insix years offollow-up. Amongmenwhoreported pre-existing periodontal disease, those with10orfewerteeth wereat increased risk ofCHD compared withmenwith25ormore teeth (relative risk = 1.67; 95%confidence interval, 1.03to 2.71), after adjustment forstandard CHD riskfactors. Amongmenwithout pre-existing periodontal disease, no relationship wasfound(relative risk = 1.11; 95%confidence interval, 0.74to1.68). Theassociations wereonlyslightly attenuated after wecontrolled fordietary factors. Nooverall associations werefoundbetween periodontal disease and coronary heart disease. Toothlossmaybeassociated with increased riskofCHD,primarily amongthosewitha positive periodontal disease history; diet wasonlyasmall mediator ofthis association.