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Observational Study
. 2019 Apr 27;19(1):98.
doi: 10.1186/s12872-019-1080-9.

Association between dental health and obstructive coronary artery disease: an observational study

Ho Lee  1 , Hack-Lyoung Kim  2 , Kwang Nam Jin  3 , Sohee Oh  4 , Yoon-Sic Han  1 , Da-Un Jung  1 , Hye-Young Sim  1 , Hee-Sun Kim  1 , Woo-Hyun Lim  5 , Jae-Bin Seo  5 , Sang-Hyun Kim  5 , Joo-Hee Zo  5 , Myung-A Kim  5
Affiliations
Observational Study

Association between dental health and obstructive coronary artery disease: an observational study

Ho Lee et al. BMC Cardiovasc Disord. .

Abstract

Background: The association between dental health and coronary artery disease (CAD) remains a topic of debate. This study aimed to investigate the association between dental health and obstructive CAD using multiple dental indices.

Methods: Eighty-eight patients (mean age: 65 years, 86% male) were prospectively enrolled before undergoing coronary CT angiography (n = 52) or invasive coronary angiography (n = 36). Obstructive CAD was defined as luminal stenosis of ≥50% for the left main coronary artery or ≥ 70% for the other epicardial coronary arteries. All patients underwent thorough dental examinations to evaluate 7 dental health indices, including the sum of decayed and filled teeth, the ratio of no restoration, the community periodontal index of treatment needs, clinical attachment loss, the total dental index, the panoramic topography index, and number of lost teeth.

Results: Forty patients (45.4%) had obstructive CAD. Among the 7 dental health indices, only the number of lost teeth was significantly associated with obstructive CAD, with patients who had obstructive CAD having significantly more lost teeth than patients without obstructive CAD (13.08 ± 10.4 vs. 5.44 ± 5.74, p < 0.001). The number of lost teeth was correlated with the number of obstructed coronary arteries (p < 0.001). Multiple binary logistic regression analysis revealed that having ≥10 lost teeth was independently associated with the presence of obstructive CAD (odds ratio: 8.02, 95% confidence interval: 1.80-35.64; p = 0.006).

Conclusions: Tooth loss was associated with the presence of obstructive CAD in patients undergoing coronary evaluation. Larger longitudinal studies are needed to determine whether there is a causal relationship between tooth loss and CAD.

Keywords: Coronary artery disease; Dental health; Inflammation; Tooth loss.

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Conflict of interest statement

Ethics approval and consent to participate

The study’s protocol was approved by the institutional review board of Boramae Medical Center (# 16–2013-34) and complied with the tenets of the 1964 Declaration of Helsinki and its later amendments. Written informed consent was obtained from all participants.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Linear association between CAD severity and number of lost teeth ANOVA, analysis of variance; VD, vessel disease; CAD, coronary artery disease
Fig. 2
Fig. 2
ROC curve analysis showing the cut-off value for number of lost teeth to predict obstructive coronary artery disease ROC, receiver-operating characteristic; AUC, area under curve; CI, confidence interval.
See this image and copyright information in PMC

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