Prior studies have shown a relationship between periodontal disease, acute myocardial infarction, and atherosclerosis. Microbes indigenous to the oral cavity and DNA of periodontal pathogens have been found in atheromatous carotid plaques. Oral pathogens may promote inflammation and thrombosis leading to atherogenesis Periodontal disease has been found associated with coronary artery, carotid, and peripheral vascular disease. The objective of this study was to determine a possible association between dental loss and aortic atherosclerotic disease. Transesophageal echocardiography (TEE) is an excellent technique to assess aortic atherosclerotic plaque.
In 115 patients (age 59 ±15 years, 63% female) referred for TEE, clinical data were recorded. Periodontal disease was determined as the number of missing teeth. Maximal aortic plaque thickness was measured by TEE. Analysis was performed to determine correlates of number of missing teeth and aortic plaque thicknes.
Univariate correlates of tooth loss were age, hypertension, aortic plaque size, Ca-channel blocker use, and a trend toward B-blocker use. There was an inverse correlation with smoking. Univariate predictors of aortic plaque thickness were age(r=. 41, p<.001), dental loss (r=.27, p=.003), and Ca-channel blocker use(p=.006). There was an inverse association with smoking. Stepwise regression demonstrated age to be the strongest predictor of aortic atherosclerosis, with dental loss and Ca-channel blocker use also found to be independent predictors.
In conclusion, aortic atherosclerosis as determined by maximal plaque size is associated with periodontal disease.
Poor dentition may be a simple clinical indicator of atherosclerosis. The association between poor dentition and aortic atherosclerosis may be related to common risk factors or to chronic inflammation.
Jason Lazar, None.