Tooth Loss and Heart Disease [Research Study]

tooth loss and heart disease
Written by Megan Rose, Physician AssistantIt’s no secret that poor dental hygiene leads to periodontal disease and eventually tooth loss. Recently, researchers who are published in the European Journal of Preventative Cardiology have correlated tooth loss with an almost doubled risk of cardiovascular death and stroke in patients with cardiovascular disease. This was the first study of its kind to compare the relationship between outcomes in those with coronary heart disease (CHD) and varying levels of tooth loss. 

The Study

Included 15,456 patients from 39 countries on five continents. These results are as a sub-study from a large clinical study studying a new medication to treat atherosclerosis, which is the medical condition of the arteries hardening over time. 

The Background

Patients were asked at the beginning of the study to complete a questionnaire about lifestyle factors (exercise, smoking, etc.), psycho-social factors (emotional health) and to place themselves in a category based on how many teeth they had in their mouths.There were five categories:
  1. All Teeth (26-32 in their mouths)
  2. Least Teeth Loss (20-25)
  3. Second Least Teeth Loss (15-19)
  4. Most Teeth Loss (less than 15 teeth remaining)
  5. No Teeth
Patients were then followed for 3.7 years and researchers counted the number of major cardiovascular events, cardiovascular deaths, strokes, and overall deaths to the patients. 

The Results

After adjusting for risk factors and socioeconomic status, when comparing the group with no teeth to those with all of their teeth, the group without any teeth had a 27% increased risk of major cardiovascular event (such as heart attack and stroke) than those in the first group, with 26-32 teeth in their mouths. They found that with each increase in the category of tooth loss as described above, there was a 6% increase in the risk of major cardiovascular events, a 14% increased risk of stroke, a 16% increased risk in overall death and a 17% increased risk of cardiovascular death. 
tooth loss and heart disease research study
Accumulated rates of medical incidents according to tooth loss level: (a) Major adverse cardiovascular events (MACEs) - cardiovascular death (CV dth), myocardial infarction (MI), or stroke; (b) cardiovascular death; (c) stroke; (d) all causes of death between 0 to 1,400 days after the allocation of groups ranked by tooth loss level (26-32, 20-25, 15-19, <15, no teeth). Chart provided by European Journal of Preventive Cardiology

So what can we do to help prevent tooth loss?

It is well documented that poor dental hygiene is one of the strongest risk factors for gum disease which is then one of the most common causes of tooth loss. While it cannot be simply concluded that gum disease directly causes consequences to the heart, observing tooth loss as an objective aspect to their overall well being could help to identify patients who may require more prevention. Furthermore, atherosclerosis can be, in part, triggered by gum disease due to the chronic inflammation that gum diseases causes. By helping these patients maintain better oral health, providers can help patients retain more of their natural teeth and thereby achieve better outcomes, especially when considering coronary heart disease. 
maintain good oral health and oral hygiene
By helping patients maintain better oral health, healthcare providers can aid in retaining their teeth.
 Looking beyond this study, when patients lose the majority (or all) of their teeth, their diets are significantly affected. It becomes necessary for patients to eat soft foods, such as white bread and noodles, soft starches (mashed potatoes), and processed produce items (applesauce) as primary staples in their diets. It is difficult or impossible to include healthy choices like fresh fruits and vegetables or nuts and seeds in their diets. The highly processed soft foods are often high in calories and low in nutrition which not only contribute to further decay on the fewer remaining teeth, but also contribute to worsening overall health issues such as heart disease.For these patients, dental implants can restore not only a new beautiful smile, but also the ability to chew those healthy foods effectively without discomfort. If you or someone you love is struggling with these kinds of issues, we can help! Article Referenced:Vedin O, Hagstrom E, Budaj A et al. Tooth loss is independently associated with poor outcomes in stable coronary heart disease. European Journal of Preventative Cardiology. December 16 2015.Featured Image: Different Types of Diseases

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