Remaining teeth, cardiovascular morbidity and death among adult Danes

OBJECTIVE: To examine if number of remaining teeth was associated with development of cardiovascular morbidity and mortality over 5-12 years.

METHODS: Prospective observational study among 1474 men and 1458 women born 1922, 1932, 1942 or 1952 from The Danish MONICA follow up study (MONItoring trends in and determinants of CArdiovascular disease) in 1987-88 and 1993-94. Subjects were followed in Danish registers for fatal and non-fatal cardiovascular disease, coronary heart disease or stroke.

RESULTS: Tooth loss was strongly associated with incidence of stroke, and to a lesser extent, incidence of cardiovascular disease and coronary heart disease, during averagely 7.5 years of follow-up. Compared to those with most teeth remaining, the edentulous suffered >3-fold increased Hazard (HR) of developing stroke (HR=3.25; 95% CI: 1.48-7.14), whereas the risk of developing any cardiovascular disease was increased by 50% (HR=1.50; 95% CI: 1.02-2.19). Risk for coronary heart disease was increased by 31%, but was not significant, after the adjustment for education, age, smoking, diabetes, alcohol intake, systolic blood pressure and body mass index (HR= 1.31; 95% CI: 0.74-2.31). Associations were similar for men and women.

CONCLUSION: These findings may have implications for future prevention of cardiovascular disease in general, and of stroke in particular, because tooth loss may serve as a simple, and early means to identify high-risk individuals.