Apical periodontitis associates with cardiovascular diseases: a cross-sectional study from Sweden

Abstract

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.

Oral health of adults with intellectual disabilities: a systematic review

“…; Virtanen et al . ; Yu, Chasman, Buring, Rose, & Ridker ). Therefore, as well as periodontitis presenting an oral health burden for adults with intellectual disabilities, it is also related to other systemic diseases which have an elevated prevalence in adults with intellectual disabilities (diabetes, respiratory disease, obesity and multimorbidity) (Cooper et al .…”

“…; U.S. Department of Health and Human Services ; Virtanen et al . ). This suggests that not only are adults with intellectual disabilities experiencing more oral health problems but that they may present with more serious systemic consequences of these diseases compared to the general population (NHS Health Scotland ; U.S. Department of Health and Human Services ).…”

“…Furthermore, there is increasing evidence that poor oral health (namely periodontal disease) is associated with cardiovascular disease, coronary heart disease, diabetes mellitus, respiratory disease and obesity (Bahekar, Singh, Saha, Molnar, & Arora 2007;Hobbins, Chapple, Sapey, & Stockley 2017;Kudiyirickal & Pappachan 2015;Nibali et al 2007;Spahr et al 2006;U.S. Department of Health and Human Services 2012; Virtanen et al 2017). This suggests that not only are adults with intellectual disabilities experiencing more oral health problems but that they may present with more serious systemic consequences of these diseases compared to the general population (NHS Health Scotland 2017; U.S. Department of Health and Human Services 2012).…”

Protective effect of alpha‐lipoic acid against apical periodontitis‐induced cardiac injury in rats

“…There is growing evidence that inflammatory diseases and infections may be the cause of and related to the emergence of cardiovascular problems . As an oral disease, AP is known to be a potential risk factor for cardiovascular diseases . Apical periodontitis and cardiovascular damage have complex etiologies and may have common general risk factors as well as pathogenic mechanisms.…”

Invited commentary: The ageing of populations across the globe and implications for the future of the dental profession

“…Many NCDs have been linked to oral infection and inflammation, with periodontitis and endodontic infections being identified as risk factors for NCDs. 1,2 These associations are supported by a wide range of studies published in both medical and dental journals. 3,4 These health trends are likely to have a profound effect on the dental profession.…”