BackgroundPeriodontal disease associates with systemic diseases but corresponding links regarding apical periodontitis (AP) are not so clear. Hence our aim was to study association between AP and the prevalence of systemic diseases in a study population from Sweden.MethodsThe subjects were 150 patients from a randomly selected epidemiological sample of 1676 individuals. 120 accepted to participate and their basic and clinical examination data were available for these secondary analyses where dental radiographs were used to record signs for endodontic treatments and AP. Periapical Index and modified Total Dental Index scores were calculated from the x-rays to classify the severity of AP and dental infection burden, respectively. Demographic and hospital record data were collected from the Swedish National Statistics Center. T-test, chi-square and univariate analysis of covariance (ANCOVA) and regressions analyses were used for statistics.ResultsOf the 120 patients 41% had AP and 61% had received endodontic treatments of which 52% were radiographically unsatisfactory. AP patients were older and half of them were smokers. AP and periodontitis often appeared in the same patient (32.5%). From all hospital diagnoses, cardiovascular diseases (CVD) were most common, showing 20.4% prevalence in AP patients. Regression analyses, controlled for age, gender, income, smoking and periodontitis, showed AP to associate with CVD with odds ratio 3.83 (95% confidence interval 1.18–12.40; p = 0.025).ConclusionsThe results confirmed our hypothesis by showing that AP statistically associated with cardiovascular diseases. The finding that subjects with AP also often had periodontitis indicates an increased oral inflammatory burden.

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Marginal bone level in this prospective study did reveal tooth groups at higher risk for progression of periodontal disease.

The aim of this study was to determine whether there is an association between self-reporting of periodontal diseases and outcome in a clinical examination, and whether any difference is present in awareness of periodontal status between smokers and non-smokers. Participants comprised 1676 adults (838 M and 838 F aged between 31 and 40 years), 564 of whom reported being smokers. Subjects were asked via questionnaire whether they thought they had periodontal disease and why. A total of 1655 subjects answered the questionnaire and were subsequently divided into those who suspected having periodontal disease (Yes-group) and those who did not (No-group). A full-mouth clinical examination was carried out in all subjects. Female smokers in the Yes-group had a significantly higher number of teeth with pockets > or = 5 mm (P < 0.001) and a higher calculus index (CI-S, P < 0.01) than female smokers in the No-group. Male smokers in the Yes-group had significantly less remaining teeth (P < 0.01), more teeth with pockets > or = 5 mm (P < 0.001), and a higher CI-S (P < 0.05) than their counterparts in the No-group. For smokers, multivariate logistic regression analysis yielded an odds ratio (OR 3.21 [95% CI 1.73 5.74]) of self-reported periodontal disease to periodontitis outcome which was significant (P < 0.001). This association remained significant (P < 0.01) after adjustment for confounding factors. Subjects who reported having periodontal disease, especially those who also reported having movable teeth, were confirmed to have the disease. Smokers were more aware of their periodontal status than non-smokers.