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Journal of Clinical Periodontology

Number of teeth, C-reactive protein, fibrinogen and cardiovascular mortality: a 15-year follow-up study in a Finnish cohort

Authors


  • Conflict of interest and source of funding statement

    The funding sources listed below had no influence in our results. This study was supported by an award from the American Heart Association #0635351N to Dr. Sok-Ja Janket. Dr. Baird is supported by NIH grants R01 EB010087 and R21 MH097639. Dr. Baird is also a co-investigator on R25 NINDS R Train, Neurology Research Education Program and U01 NINDS NeuroNEXT Clinical Trials (U01) at SUNY Downstate Medical Center. Dr. Jackson is supported by NIH grants R01 AG-045136, RO1 HL115295 and U01 NR004061. Dr. Meurman is supported by the Medical Society of Finland and Helsinki University Central Hospital Research Funds. Dr. Van Dyke is supported in part by USPHS grant DE15566.

Abstract

Aim

To test whether the number of teeth, an inverse proxy for composite oral infection scores is associated with better survival.

Materials and Methods

The Kuopio Oral Health and Heart study initiated a case–control study in 1995–1996 consisting of 256 consecutive coronary artery disease patients and 250 age and gender-matched controls. We appended the mortality data and formulated a longitudinal study. By May 31st, 2011, 124 mortalities had occurred and 80 of which were of cardiovascular origin. Using Cox proportional hazards models, we assessed the association of the teeth group (Teethgrp) – consisting of 10 teeth – with cardiovascular and all-cause mortality after 15.8 years of median follow-up.

Results

In multivariate models, with the edentulous state as reference, one level increase in Teethgrp was associated with significantly increased survival from cardiovascular disease (CVD) mortality with a Hazard Ratio (HR) 0.73, p-value = 0.02 but not with all-cause mortality (HR = 0.87, p = 0.13). The findings were not mediated by C-reactive protein (CRP) levels ≥3 mg/L or by median fibrinogen levels, but were mediated by CRP levels >5 mg/L.

Conclusion

Each increment of 10 teeth from the edentulous state was associated with a 27% improved CVD survival, independent of low-grade systemic inflammation.

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