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Periodontitis, edentulism linked to higher mortality but not CVD in older women
Periodontitis and edentulism in postmenopausal women are associated with increased mortality rate but not increased risk for CVD after adjusting for confounding factors, according to published findings.
“Moderate to severe periodontitis and edentulism are present in about 64% and 33% of U.S. adults 60 years and older, respectively,” Michael J. LaMonte, PhD, MPH, research associate professor in the department of epidemiology and environmental health at the State University of New York at Buffalo, and colleagues wrote in the study background. “Periodontitis and tooth loss have been associated with higher risk of atherosclerotic CVD and total mortality. Few studies have included older adults or, specifically, women, and in those that have, inconsistent results were reported.”
Participants (n = 57,001; mean age, 68 years) were from the Women’s Health Initiative study. They were postmenopausal and had no known CVD when the history of tooth decay/loss was assessed through self-reporting.
Through the questionnaire at year 5, 26% of participants reported having periodontitis and 5.9% reported edentulism.
The primary outcome of the study was total CVD (nonfatal MI, cardiac death, stroke, pulmonary embolism and HF).
During the mean follow-up of 6.7 years, there were 3,589 incidents of CVD events and 3,816 total deaths, the researchers wrote.
In a multivariable analysis, periodontitis was associated with higher total mortality (HR = 1.12; 95% CI, 1.05-1.21), but it was not associated with CVD events. Edentulism was associated with CVD (HR = 1.42; 95% CI, 1.27-1.59) when adjusted for age and smoking related risks, but that association was no longer significant after further adjustment, according to the researchers.
Edentulism was associated with increased mortality (HR = 1.17; 95% CI, 1.02-1.33) after adjustment for CVD risk factors.
The results were consistent by age, race/ethnicity, smoking status and diabetes status, but edentulism had a stronger association with CVD in women with at least one annual dental visit (HR = 1.57) vs. women who had less frequent dental visits (HR = 1.03; P for interaction = .004), according to the researchers.
“Our findings suggest that older women may be at higher risk for death because of their periodontal condition and may benefit from more intensive oral screening measures,” LaMonte said in a press release. “However, studies of interventions aimed at improving periodontal health are needed to determine whether risk of death is lowered among those receiving the intervention compared to those who do not. Our study was not able to establish a direct cause and effect.” – by Cassie Homer
Disclosure: The researchers report no relevant financial disclosures.