Losing two or more teeth during middle age is associated with increased cardiovascular disease (CVD) risk, according to recently presented findings at the American Heart Association’s Epidemiology and Prevention | Lifestyle and Cardiometabolic Health Scientific Session 2018 on March 21 in New Orleans.

Studies have shown dental health problems, including periodontal disease and tooth loss are related to inflammation, diabetes, smoking and consuming unhealthy or less healthy diets.

“Previous research has also found that dental health issues are associated with elevated risk of cardiovascular disease,” said lead author Lu Qi, MD, PHD, Tulane University in New Orleans and colleagues. “However, most of that research looked at cumulative tooth loss over a lifetime, which often includes teeth lost in childhood due to cavities, trauma and orthodontics. Tooth loss in middle age is more likely related to inflammation, but it hasn’t been clear how this later-in-life tooth loss might influence cardiovascular disease risk.”

To assess the impact of tooth loss on CVD risk, Qi and colleagues analyzed large studies of middle-aged (45 to 69) adults who did not exhibit CVD. They reported the number of natural teeth they possessed. In a follow up questionnaire, they reported recent tooth loss.

The researchers studied tooth loss occurrence in the cohort over an eight-year period and followed the incidences of CVD in study subjects with no tooth loss, one tooth lost, and two or more teeth lost over 12-18 years.

In individuals with 25 to 32 natural teeth at the start of the study, those who lost two or more teeth had a 23 percent increased risk of CVD, compared to subjects with no tooth loss. People with less than 17 natural teeth at the start of the study had a 25 percent increased risk of CVD.

There was no notable increase in CVD among study subjects who reported losing only one tooth.

CVD risk among the entire cohort, regardless of natural tooth count at the start of the study, increased 16 percent among those who lost two or more teeth during the study, compared to those who didn’t lose teeth.

“In addition to other established associations between dental health and risk of disease, our findings suggest that middle-aged adults who have lost two or more teeth in recent past could be at increased risk for cardiovascular disease,” Qi said. “That’s regardless of the number of natural teeth a person has as a middle-aged adult, or whether they have traditional risk factors for cardiovascular disease, such as poor diet or high blood pressure.”

Qi noted a limitation of the study was the cohort self-reported their tooth loss.