Number of teeth, C-reactive protein, fibrinogen and cardiovascular mortality: a 15-year follow-up study in a Finnish cohort

AimTo test whether the number of teeth, an inverse proxy for composite oral infection scores is associated with better survival. Materials and MethodsThe Kuopio Oral Health and Heart study initiated a case-control study in 1995-1996 consisting of 256 consecutive coronary artery disease patients and 250 age and gender-matched controls. We appended the mortality data and formulated a longitudinal study. By May 31st, 2011, 124 mortalities had occurred and 80 of which were of cardiovascular origin. Using Cox proportional hazards models, we assessed the association of the teeth group (Teethgrp) - consisting of 10 teeth - with cardiovascular and all-cause mortality after 15.8years of median follow-up. ResultsIn multivariate models, with the edentulous state as reference, one level increase in Teethgrp was associated with significantly increased survival from cardiovascular disease (CVD) mortality with a Hazard Ratio (HR) 0.73, p-value=0.02 but not with all-cause mortality (HR=0.87, p=0.13). The findings were not mediated by C-reactive protein (CRP) levels 3mg/L or by median fibrinogen levels, but were mediated by CRP levels >5mg/L. ConclusionEach increment of 10 teeth from the edentulous state was associated with a 27% improved CVD survival, independent of low-grade systemic inflammation.