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(Stroke. 2006;37:2271.)
© 2006 American Heart Association, Inc.

Original Contributions

Dental and Periodontal Status and Risk for Progression of Carotid Atherosclerosis

The Inflammation and Carotid Artery Risk for Atherosclerosis Study Dental Substudy

Thomas Schillinger; Wolf Kluger, MD; Markus Exner, MD; Wolfgang Mlekusch, MD; Schila Sabeti, MD; Jasmin Amighi, MD; Oswald Wagner, MD; Erich Minar, MD Martin Schillinger, MD

From the Clinic of Dentistry (T.S., W.K.), the Medical Department, Chemical Laboratory Diagnostics (M.E., O.W.), and the Department of Angiology (W.M., S.S., J.A., E.M., M.S.), Medical University, Vienna, Austria.

Correspondence to Martin Schillinger, MD, Department of Internal Medicine II, Division of Angiology, University of Vienna, Medical School, Waehringer Guertel 18-20, A-1090 Vienna, Austria. E-mail martin.schillinger{at}meduniwien.ac.at

Background and Purpose— Dental and periodontal disease are potentially involved in the pathogenesis of atherosclerosis. We investigated whether dental and periodontal status is associated with the presence and future progression of carotid stenosis.

Methods— We randomly selected 411 of 1268 participants from the prospective Inflammation and Carotid Artery Risk for Atherosclerosis Study and evaluated dental and periodontal status and oral hygiene at baseline measuring three World Health Organization-validated indices: DMFT (decayed, missing, filled teeth), SLI (Silness-Löe Index), and CPITN (community periodontal index for treatment needs), respectively. The degree of carotid stenosis was measured by duplex ultrasound at baseline and after median 7.5 months (range=6 to 9 months) to identify patients with progressive carotid stenosis.

Results— DMFT (P<0.01), SLI (P=0.048), CPITN (P=0.007), and edentulousness (P=0.007) were associated with the baseline degree of carotid stenosis. Atherosclerosis progression was observed in 48 of 411 patients (11.7%). DMFT (adjusted odds ratio [OR]=1.11, 95% CI=1.01 to 1.22, P=0.032) and SLI (adjusted OR=1.77, 95% CI=1.09 to 2.79, P=0.021), but not CPITN (adjusted OR=1.51, 95% CI=0.89 to 2.45, P=0.16) were significant predictors of disease progression, irrespective of traditional cardiovascular risk factors and the baseline degree of stenosis. Edentulous patients had a significantly increased risk for disease progression as compared with patients with teeth (adjusted OR=2.10, 95% CI=1.06 to 4.16, P=0.33).

Conclusion— Dental status, oral hygiene, and particularly tooth loss are associated with the degree of carotid stenosis and predict future progression of the disease.

Key Words: atherosclerosis • carotid • dental • periodontal • plaque

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