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Poor Oral Health and Coronary Heart Disease

Department of Oral Health Policy & Epidemiology, Harvard School of Dental Medicine, 188 Longwood Avenue, Room 004, Boston, Massachusetts 02115, Department of Epidemiology, Harvard School of Public Health

E.B. Rimm

Department of Epidemiology, Harvard School of Public Health, Department of Nutrition, Harvard School of Public Health

C.W. Douglass

Department of Oral Health Policy & Epidemiology, Harvard School of Dental Medicine, 188 Longwood Avenue, Room 004, Boston, Massachusetts 02115, Department of Epidemiology, Harvard School of Public Health

D. Trichopoulos

Department of Epidemiology, Harvard School of Public Health

A. Ascherio

Department of Epidemiology, Harvard School of Public Health, Department of Nutrition, Harvard School of Public Health

W.C. Willett

Department of Epidemiology, Harvard School of Public Health, Department of Nutrition, Harvard School of Public Health, Channing Laboratory, Harvard Medical School, Department of Medicine, Brigham and Women's Hospital

A few recent studies have shown associations between poor oral health and coronary heart disease (CHD). The objective of this study was to examine the incidence of CHD in relation to number of teeth present and periodontal disease, and to explore potential mediators of this association, in a prospective cohort study. This study is a part of the ongoing Health Professionals Follow-Up Study (HPFS). Participants included a US national sample of 44,119 male health professionals (58% of whom were dentists), from 40 to 75 years of age, who reported no diagnosed CHD, cancer, or diabetes at baseline. We recorded 757 incident cases of CHD, including fatal and non-fatal mvocardial infarction and sudden death, in six years of follow-up. Among men who reported pre-existing periodontal disease, those with 10 or fewer teeth were at increased risk of CHD compared with men with 25 or more teeth (relative risk = 1.67; 95% confidence interval, 1.03 to 2.71), after adjustment for standard CHD risk factors. Among men without pre-existing periodontal disease, no relationship was found (relative risk = 1.11; 95% confidence interval, 0.74 to 1.68). The associations were only slightly attenuated after we controlled for dietary factors. No overall associations were found between periodontal disease and coronary heart disease. Tooth loss may be associated with increased risk of CHD, primarily among those with a positive periodontal disease history; diet was only a small mediator of this association.

Key Words: coronary heart disease • periodontal disease • edentulousness • diet • infection.

Journal of Dental Research, Vol. 75, No. 9, 1631-1636 (1996)
DOI: 10.1177/00220345960750090301


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