ORLANDO, Fla. — Professional dental screening and cleaning may reduce the
risks for stroke and MI, researchers said here.
Zu-Yin Chen, MD, a cardiology fellow at Veterans General
Hospital, Taipei, Taiwan, and colleagues investigated whether preventive dental
care reduces risks for CVD.
“Because oral health has been previously associated with increased
risk for heart disease, we wanted to see if tooth scaling could help decrease
risk,” Chen said in an interview. “Many studies have shown that tooth
scaling could improve inflammation markers — a cause for plaque in vessels
and risk for stroke and heart disease — but we didn’t know if that
translated to less risk for stroke and heart attack.”
Chen and colleagues evaluated records from 51,108 adults without
previous history of stroke or MI who had received full or partial mouth scaling
at least once from the Taiwan National Health insurance. They also matched
51,512 control patients using age, sex and comorbidities with no history of
stroke or MI who had never received a mouth scaling.
After 7 years, patients who received mouth scalings had a lower
incidence of acute MI (0.44% vs. 0.55%; P=.013) and stroke (2.27% vs.
2.57%; P=.002), as compared with the control group. Patients with tooth
scaling also had significantly higher acute MI-free (P=.027) and
stroke-free (P=.04) survival rates. Cox proportional hazard regression
analysis highlighted tooth scaling as the independent factor associated with
lower risk for developing future MI (HR=0.76; 95% CI, 0.6-0.96) and stroke
(HR=0.87; 95% CI, 0.78-0.96).
Additionally, the researchers discovered a relationship between
frequency of tooth scaling and CV risk reduction. For MI, often and occasional
tooth scaling was associated with a HR of 0.76 (95% CI, 0.6-0.96) whereas no
tooth scaling was associated with a HR of 0.87 (95% CI, 0.71-1.07). Likewise,
for stroke, often and occasional tooth scaling was associated with a HR of 0.87
(95% CI, 0.78-0.96) and no tooth scaling was associated with a HR of 0.91 (95%
“Oral health is important. We should take care of our teeth as
well as other parts of our bodies,” Chen said. “However, we should
never forget other important risk factors, such as smoking, cholesterol and
In another study presented here, Anders Holmlund, DDS, PhD, of
the Centre for Research and Development of the County Council of Gavleborg,
Sweden, and colleagues conducted a study to explore the link between markers of
periodontal disease and MI, stroke and heart failure. The study included 7,999
patients referred to a clinic for periodontal treatment between 1976 and 2008.
All received a full mouth dental examination, including X-ray. The researchers
compared various points of oral health, such as number of remaining teeth,
periodontal severity index, number of deepened periodontal pockets and bleeding
on probing, on risks for fatal or nonfatal MI, HF and stroke.
During a mean follow-up of more than 13 years, the researchers
identified 414 cases of fatal or nonfatal MI, 204 cases of HF and 438 cases of
Analyses adjusted for age, sex, smoking and education level revealed a
significant association between MI and number of remaining teeth (HR=1.69; 95%
CI, 1.02-2.81) and number of deepened periodontal pockets (HR=1.53; 95% CI,
1.03-2.27). Patients with fewer than 21 teeth had a 69% increased risk for MI
compared with those with the most teeth, according to the study. Further, the
risk for congestive HF was 2.5 times higher among patients with the fewest
teeth compared with those with the most teeth. A greater number of deepened
periodontal pockets, suggesting infection of the gum around the base of the
tooth, was associated with a 53% increased risk for MI compared with those with
the fewest deepened pockets. Risk for stroke was also 2.1 times higher among
patients with the highest incidence of gum bleeding compared with those with
the lowest incidence.
“Although it is a bit too early to draw any final conclusions
regarding the clinical application [of these findings], it seems that the
number of teeth has the potential to be an easily obtained risk indicator for
future CVD,” Holmlund told Cardiology Today. – by
For more information:
Disclosure: Drs. Chen and Holmlund report no relevant financial
The association between tooth scaling or dental cleaning and CVD is
intriguing from an epidemiology perspective. It's an association, which means
that we don't know yet the direction of causation. For instance, is this due to
having poor health habits, such as smoking and other poor behaviors? Right now,
this is unclear, and these data were not able to address that question, so we
need further work in this area.
- Donna Arnett, PhD
President-Elect of the American
Epidemiologist, School of Public Health
University of Alabama
Disclosure: Dr. Arnett reports no relevant financial disclosures.