A recent US study has linked losing one or more teeth in middle age to heart disease

There have been a number of studies looking at the association between gum disease and heart health and a recent US study has linked losing one or more teeth in middle age to heart disease.

The study, which was presented at the 2018 American Heart Association’s Epidemiology and Prevention, Lifestyle and Cardiometabolic Health Scientific Sessions earlier this year, analysed data from two long term studies.

The participants were between 45 and 69 years old at the outset and did not have heart disease. They were asked about the number of natural teeth first in 1986 in and in 1992 and in follow-up questionnaires participants reported whether they had any recent tooth loss.

According to the findings, adults with 25 to 32 natural teeth at the beginning of the study who lost two or more teeth during follow-up had a 23 per cent increased risk of coronary heart disease compared with those who didn’t lose any teeth. This was true after adjusting for diet quality, physical activity, body weight, hypertension and other cardiovascular risk factors.

Losing just one tooth during the study period was not associated with a notable increased risk of heart disease.

Gingiva is a clinical term used to describe the gums and gingivitis, also known as gum disease, is where the gums are red or inflamed due to a build-up of plaque. Left untreated gingivitis can lead to peridontitis or periodontal disease, which can result in tooth loss.

According Dr Ray McCarthy, restorative dentist with the Fitzwilliam Dental Practice in Dublin, there is increasing awareness that periodontal disease and cardiovascular disease (CVD) may be associated on the basis that active periodontal infection will stimulate an immune response in the body that may lead to inflammation driven changes in coronary blood vessels.

However, he said the jury was still out on this and a review in 2017 summarised the evidence as being of low quality which “did not support or refute the contention that periodontal treatment can prevent the recurrence of cardiovascular disease in patients with gum disease or play an identifiable role in the prevention of CVD.”

“While we don’t yet have “a smoking gun” in terms of casual linkage between poor periodontal or oral health and hygiene to CVD, on the balance of the evidence that we do have, it would seem desirable to optimise oral health to minimise the risk for CVD,” Dr McCarthy concluded.