Public Release: 

Tooth loss and heart disease linked, even among nonsmokers

Center for Advancing Health

There is a strong, progressive association between tooth loss and heart disease, researchers report in a study published in the latest issue of American Journal of Preventive Medicine.

Heart disease was present in 4.7 percent of those without tooth loss, 5.7 percent of those with 1 to 5 missing teeth, 7.5 percent of those with 6 to 31 missing teeth, and 8.5 percent of those with total tooth loss, reports lead investigator Catherine Okoro, epidemiologist in the Division of Adult and Community Health at the Centers for Disease Control and Prevention.

This finding emerged after adjusting for sex, race and ethnicity, education, marital status, diabetes, smoking status, alcohol consumption, high blood pressure, high blood cholesterol and body mass index, Okoro said.

The researchers analyzed data from 41,891 respondents to the 1999-2002 Behavioral Risk Factor Surveillance System survey, which involved adults age 40 to 79 years old in 22 states and the District of Columbia. The survey was conducted by telephone.

The investigators noted that the results of this study are consistent with previous studies that link periodontal disease and tooth loss to an increased risk of atherosclerosis and heart attack.

However, they said that other studies had not shown an association between oral conditions and heart disease.

Okoro emphasized that the correlation between tooth loss and heart disease held even when smoking status was considered. "Smoking has strong relationships to both tooth loss and heart disease. Nonetheless, when we stratified by age group and smoking status, a significant association remained between tooth loss and heart disease among respondents aged 40 to 59 years who had never smoked."

Okoro said the relationship between tooth loss and heart disease is of considerable public health interest because of the prevalence of both conditions in the general population. "These results highlight the importance of health promotion counseling that includes the promotion of heart-healthy behaviors, the prevention and control of cardiovascular disease risk factors and the maintenance of good oral health," she said.

Sounding a note of caution about over-interpreting the study results, James Beck, Distinguished Professor of Dental Ecology at the University of North Carolina at Chapel Hill said, "If you believe that the data are reasonable estimates of the cardiovascular and oral status of those interviewed, then you must understand, as the authors point out, that one cannot determine from this study whether people with poor oral status are at greater risk for cardiovascular disease. We only know that the two conditions are related to one another."

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INTERVIEWS Contact Catherine Okoro at Cokoro@cdc.gov
American Journal of Preventive Medicine: Contact the editorial office at (858) 457-7292.

Okoro CA, et al. Tooth loss and heart disease: findings from the behavioral risk factor surveillance system. Am J Prev Med 29(4,suppl) 2005

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