The Association of Tooth Scaling and Decreased Cardiovascular Disease: A Nationwide Population-based Study

Chen, Zu Yin; Chiang, Chi‐Lu; Huang, Chin Chou; Chung, Chia Min; Chan, Wan Leong; Huang, Po Hsun; Lin, Shing Jong; Chen, Jaw Wen; Leu, Hsin Bang

doi:10.1016/j.amjmed.2011.10.034

Cited by 50 publications

(51 citation statements)

References 39 publications

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“…35 Results of a recently published population-based study in Taiwan suggests that maintenance of periodontal health by dental prophylaxis and PD treatment can help reduce the incidence of ischemic stroke. 36, 37 Further studies are needed to assess whether PD treatment can lead to reduction in serum inflammatory markers and prevent recurrent vascular events in stroke/TIA patients. Finally, we did not measure medical therapy non-compliance, known to adversely impacts outcomes in stroke/TIA patients.…”

Section: Discussionmentioning

confidence: 99%

Periodontal Disease and Recurrent Vascular Events in Stroke/Transient Ischemic Attack Patients

Sen

Sumner

Hardin

et al. 2013

Journal of Stroke and Cerebrovascular Diseases

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Periodontal disease has been shown to be associated with incident stroke. We investigated whether periodontal disease is independently associated with recurrent vascular events and certain inflammatory markers in stroke/TIA patients. In this prospective longitudinal hospital-based cohort study, periodontal disease was assessed in stroke/TIA patients. High periodontal disease was defined as the highest tertile of extent (% of sites) with attachment loss ≥ 5 mm. Serum interleukin-6, high sensitivity C-reactive protein and soluble intracellular adhesion molecule-1 were measured. The patients were followed for recurrent vascular events-stroke, TIA, myocardial infarction and vascular death. In the 106 patients that were evaluated, 40 (38%) showed high periodontal disease and 27 (26%) had recurrent vascular events over a median of 24 months (range 12–24 months). High periodontal disease patients had higher levels of interleukin-6 (p=0.01) and soluble intracellular adhesion molecule-1 (p=0.03). High periodontal disease was associated with recurrent vascular events before (Log rank p=0.01, hazard ratio 2.6, 95% CI, 1.2–5.7) and after adjustment for significant confounders -age and stroke status (Hazard Ratio 2.5, 95% confidence interval, 1.1 to 5.5, p=0.03); adjustment for possible confounders age, males, years of education and cardioembolic strokes (hazard ratio 2.8, 95% confidence interval, 1.2–6.5, p=0.02); and adjustment for propensity score that accounted for all potential measured confounders (hazard ratio 2.8, 95% confidence interval,1.2–6.5, p=0.02). There is an independent association between high periodontal disease and recurrent vascular events in stroke/TIA patients. High periodontal disease is also associated with higher serum levels of interleukin-6 and soluble intracellular adhesion molecule-1.

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Section: Discussionmentioning

confidence: 99%

Periodontal Disease and Recurrent Vascular Events in Stroke/Transient Ischemic Attack Patients

Sen

Sumner

Hardin

et al. 2013

Journal of Stroke and Cerebrovascular Diseases

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“…A comprehensive longitudinal study in Taiwan with an average follow-up period of 7 years was based on a random sample of one million people [32]. It was attended by 10,887 people, who had received dental treatment during the study period.…”

Section: Significance Of Periodontal Treatmentmentioning

confidence: 99%

“…Furthermore, there was a dose-dependent correlation with increased frequency of scaling leading to greater reduction in the risk of AMI and stroke. A weakness of this study was, however, that correction for all known risk factors such as smoking was not performed [32]. In a recent longitudinal study, also from Taiwan, 13,573 patients were treated for mild PDIS in the period 2001–2010, and an equal number of matched patients were treated for severe PDIS [33].…”

Section: Significance Of Periodontal Treatmentmentioning

confidence: 99%

Comorbidity of periodontal disease: two sides of the same coin? An introduction for the clinician

Holmstrup

Damgaard

Olsen

et al. 2017

Journal of Oral Microbiology

157

140

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Increasing evidence has suggested an independent association between periodontitis and a range of comorbidities, for example cardiovascular disease, type 2 diabetes, rheumatoid arthritis, osteoporosis, Parkinson’s disease, Alzheimer’s disease, psoriasis, and respiratory infections. Shared inflammatory pathways are likely to contribute to this association, but distinct causal mechanisms remain to be defined. Some of these comorbid conditions may improve by periodontal treatment, and a bidirectional relationship may exist, where, for example, treatment of diabetes can improve periodontal status. The present article presents an overview of the evidence linking periodontitis with selected systemic diseases and calls for increased cooperation between dentists and medical doctors to provide optimal screening, treatment, and prevention of both periodontitis and its comorbidities.

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“…A group of patients who were exposed to tooth scaling had lower rates of acute myocardial infarction (1.6% vs. 2.2%, p<0.001), stroke (8.9% vs. 10%, p=0.03), and total CVD (10% vs. 11.6%, p<0.001) in comparison to a non-exposed group. Furthermore, more frequent tooth scaling was correlated with a greater risk reduction (6). However, the effects of therapeutic periodontal intervention on CVD vary according to the different treatment modalities, which remain controversial and require further investigation (7).…”

Section: Introductionmentioning

confidence: 99%

Periodontal Treatment and the Risks of Cardiovascular Disease in Patients with Type 2 Diabetes: A Retrospective Cohort Study

et al. 2017

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Objective Periodontal disease may predispose individuals to cardiovascular disease (CVD). Diabetes mellitus, especially in patients with severe periodontitis, increases the risk of CVD mortality. However, the outcomes of periodontal therapy vary among the different treatment modalities. We aim to investigate whether periodontal treatment could influence the occurrence of CVD in patients with type 2 diabetes and periodontal problems. Methods A retrospective cohort study was conducted based on a dataset released by Taiwan National Health Insurance (NHI). The dataset was composed of randomly sampled, newly diagnosed diabetic patients who received insurance benefits from 1999 to 2001; patients who were younger than 18 years of age or who already had CVD before 1999 were excluded. The NHI code was used to identify the treatments, including subgingival curettage and flap operations. The patients' demographic variables were matched using a 1:4 propensity score. All of the subjects were followed up until the onset of CVD, or December 31, 2011. A Cox proportional hazards regression analysis was performed to evaluate the effects of periodontal treatment on the rates of myocardial infarction, heart failure and stroke. Results Three thousand thirty-nine and 12,156 diabetic subjects were classified into the advanced periodontal treatment group and the non-advanced periodontal treatment group, respectively. The Cox proportional hazards analysis revealed that although the overall incidence of CVD was not significantly improved (Hazard ratio, HR 0.95; 95% CI 0.90-1.01), advanced periodontal treatment reduced the rates of myocardial infarction (HR 0.92; 95% CI 0.85-0.99) and heart failure (HR 0.60; 95% CI 0.45-0.80). There was no significance difference in the incidence of stroke (HR 0.95; 95% CI 0.85-1.06). Conclusion Advanced periodontal therapy lowers the rate of CVD, especially myocardial infarction and heart failure. Dental management has a beneficial effect on the health of patients with type 2 diabetes.

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The Association of Tooth Scaling and Decreased Cardiovascular Disease: A Nationwide Population-based Study

Cited by 50 publications

References 39 publications

Periodontal Disease and Recurrent Vascular Events in Stroke/Transient Ischemic Attack Patients

Periodontal Disease and Recurrent Vascular Events in Stroke/Transient Ischemic Attack Patients

Comorbidity of periodontal disease: two sides of the same coin? An introduction for the clinician

Periodontal Treatment and the Risks of Cardiovascular Disease in Patients with Type 2 Diabetes: A Retrospective Cohort Study

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