on July 31, 2003
Published online before print July 31, 2003, doi: 10.1161/01.STR.0000085086.50957.22
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Submitted on April 2, 2003
From the Division of Epidemiology, School of Public Health (M.D., R.T.D., D.R.J.) and Department of Medicine, Medical School (M.D.), University of Minnesota, Minneapolis; and Department of Neurology, Columbia University College of Physicians and Surgeons (T.R., B.B.-A., R.L.S.), and Division of Periodontics, Columbia University School of Dental and Oral Surgery (P.N.), New York, NY. * To whom correspondence should be addressed. E-mail: Desvarieux{at}epi.umn.edu.
Background and Purpose--Chronic infections, including periodontal infections, may predispose to cardiovascular disease. The present study investigates the relationship of periodontal disease and tooth loss with subclinical atherosclerosis. Methods--We enrolled 711 subjects with a mean age of 66±9 years and no history of stroke or myocardial infarction in the Oral Infections and Vascular Disease Epidemiology Study. Subjects received a comprehensive periodontal examination, extensive in-person cardiovascular disease risk factor measurements, and a carotid scan using high-resolution B-mode ultrasound. Regression models were adjusted for conventional risk factors (age, sex, smoking, diabetes, systolic blood pressure, low- and high-density lipoprotein cholesterol, race-ethnicity, education, physical activity) and markers of cultural background, healthy lifestyle, and psychosocial health. Results--Measures of both current and cumulative periodontitis became more severe as tooth loss increased. A significant association was observed between tooth loss levels and carotid artery plaque prevalence. Among those with 0 to 9 missing teeth, 46% had carotid artery plaque, whereas among those with Conclusions--Our data suggest that tooth loss is a marker of past periodontal disease in this population and is related to subclinical atherosclerosis, thereby providing a potential pathway for a relationship with clinical events.
Accepted on April 14, 2003
Relationship Between Periodontal Disease, Tooth Loss, and Carotid Artery Plaque. The Oral Infections and Vascular Disease Epidemiology Study (INVEST)
Moïse Desvarieux MD, PhD*;
10 missing teeth, carotid artery plaque prevalence was 
60% (P<0.05).
Key words: atherosclerosis • infection • periodontal disease • tooth loss
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