Aim(s) To test whether the number of teeth, an inverse proxy for composite oral infection scores is associated with better survival. Materials and Methods The Kuopio Oral Health and Heart study initiated a case-control study in 1995–1996 consisting of 256 consecutive coronary artery disease patients and 250 age and gender matched controls. We appended the mortality data and formulated a longitudinal study. By May 31st, 2011, 124 mortalities had occurred and 80 of which were of cardiovascular origin. Using Cox proportional hazards models, we assessed the association of the teeth group (Teethgrp) – consisting of 10 teeth – with cardiovascular and all-cause mortality after 15.8 years of median follow-up. Results In multivariate models, with the edentulous state as reference, one level increase in Teethgrp was associated with significantly increased survival from cardiovascular (CVD) mortality with a Hazard Ratio (HR) 0.73, P-value = 0.02 but not with all-cause mortality (HR= 0.87, p=0.13). The findings were not mediated by CRP levels ≥ 3 mg/L or by median fibrinogen levels but were mediated by CRP levels > 5 mg/L. Conclusion Each increment of 10 teeth from the edentulous state was associated with a 27% improved CVD survival, independent of low-grade systemic inflammation.

Having ≥1 root filled teeth was associated with significantly lower odds for prevalent CAD cross sectionally and lower risk of cardiovascular mortality prospectively. These reduced associations with CVD were independent of periodontitis or serum CRP levels.

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Periodontitis is a chronic infectious-inflammatory disease associated with dysbiotic dental plaque biofilms characterized by the destruction of the tooth-supporting tissues (periodontal ligament and alveolar bone). 1 This disease has a high global prevalence in different populations, [2][3][4][5][6] and there is mounting evidence that is independently associated with different systemic diseases and co-morbidities, either directly by bacterial invasion or indirectly through systemic inflammation. [7][8][9][10][11][12] These include hypertension, 13 coronary heart disease (CHD) 14 obesity, 15 adverse pregnancy outcomes, 16 diabetes mellitus, 17,18 and autoimmune diseases such as rheumatoid arthritis 19 and cancer. 20,21 Periodontitis has also shown a significant impact in general health care as demonstrated from insurance data 22 and in patients attending for dental care. 23 There is also epidemiologic evidence demonstrating that subjects with periodontitis have