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SAN FRANCISCO, Calif., USA: Although many studies have provided evidence of a link between periodontitis and coronary heart disease, there is insufficient scientific data on periodontal disease and patients with established heart disease. Therefore, U.S. researchers investigated the dental health of such patients and found that having fewer teeth was associated with a number of cardiovascular risk factors, including diabetes and smoking, among others.

Data for the study was obtained from the Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy Trial, an ongoing global clinical trial aimed at establishing whether darapladib, a potential add-on drug for atherosclerosis, can safely lower the risk of a cardiovascular event in people with coronary heart disease.

Number of teeth, frequency of gum bleeding and cardiovascular risk factors were recorded for the more than 15,800 patients from 39 countries who are participants in the trial. About 40 percent have fewer than 15 teeth and 16 percent are edentulous. A quarter of the participants reported gum bleeding.

Among other findings, the researchers observed that a decreasing number of teeth was associated with increasing levels of Lp-PLA2, an enzyme that induces inflammation and promotes the development of atherosclerosis. In addition, patients with fewer teeth were more likely to have diabetes and to be current or former smokers. Moreover, gum bleeding, an early manifestation of periodontal disease, was associated with high blood pressure and higher levels of LDL, a lipoprotein that may promote cardiovascular disease.

Although these findings suggest a close link between tooth loss, gum health and cardiovascular health, whether periodontal disease actually causes coronary heart disease remains to be shown, Dr. Ola Vedin, from the Department of Medical Sciences at Uppsala University in Sweden, added. Additional studies are needed to unravel the potential of periodontal health as a useful marker for heart disease. If future research can confirm a causal relationship, dentists could play an important role in cardiovascular risk assessment.

The study, titled "Tooth Loss is Highly Prevalent and Associated with Cardiovascular Risk Factors in Patients with Chronic Coronary Heart Disease in the Global Stability Trial," was published in the March 12 supplement of the Journal of the American College of Cardiology. Vedin presented the study results at ACC's annual scientific session in San Francisco, which was held from March 9 to 11.