Strong Connection Found Between Number of Teeth and CVD Mortality

Dr. Sok-Ja Janket
Dr. Sok-Ja Janket

Research Associate Professor Dr. Sok-Ja Janket and her team further strengthened the oral health/cardiovascular disease link in the November 12, 2013, Journal of Clinical Periodontology.  The paper, “Number of teeth, C-reactive protein, fibrinogen and CVD mortality,” is the first study to mathematically quantify the relationship between tooth count and oral inflammation.

Researchers looked at the association between number of teeth (in groups of 10 teeth) and cardiovascular and all-cause mortality to determine if having more teeth is linked to better survival. They used baseline data from the Kuopio Oral Health and Heart study of 256 people with coronary artery disease and appended mortality data during the span of 15 years to create a longitudinal study.

The results of this study indicated that with every additional 10 teeth a person had, cardiovascular survival increased significantly—by 27 percent. Interestingly, there was no significant improvement in the survival from all-cause mortality.

Dr. Janket pointed out several areas where this study improved on past research on this topic. The study:

  • proved that baseline disease prevalence does not really affect the risk estimation if we use time-to-event analyses.
  • adjusted potential confounding factors reasonably well, which plagued other previous studies.
  • additionally adjusted for systemic inflammation, which other previous studies did not do successfully.
  • quantified the effects of oral infection to systemic inflammation.

“Most importantly, when oral infection is controlled, the well-known systemic inflammation marker CRP in the lower levels was inversely associated with cardiovascular mortality,” she said. Dr. Janket postulated that this might be a case where CRP can be anti-inflammatory as previous molecular studies have suggested.

Authors included Dr. Janket; Dr. Alison E. Baird, SUNY Downstate Medical Center; Dr. Judith A. Jones, GSDM Chair of the Department of General Dentistry; Dr. Elizabeth A. Jackson, University of Michigan; Dr. Markku Surraka, Kuopio University; Ms. Wen Tao, Boston University; Dr. Jukka H. Meurman, University of Helsinki; and Dr. Thomas E. Van Dyke, Forsyth Institute.

The study was supported by an award from the American Heart Association to Dr. Janket.