We have long known about the associations between gum disease and heart disease, but now a large, new review gives us our strongest, starkest statement on the link: tooth loss can almost double your risk of death. That’s from a new review of more than 15,000 coronary heart disease patients showing that the number of teeth was directly related to a person’s risk of serious heart problems, including death.
Five Continents, One Result
The new data comes from the STABILITY trial, a very large drug trial on arterial plaque treatment. The trial included 15,456 patients from 39 countries on five continents. To eliminate confounders that could obscure results, patients were surveyed about various lifestyle factors, including smoking, physical activity, psychological factors, and tooth loss. For tooth loss, patients were grouped into five categories:
- 26-32 teeth (considered all teeth)
- 20-26 teeth
- 15-19 teeth
- 1-14 teeth
- No teeth
Researchers noted that tooth loss was common. About 16% of patients had lost all their teeth, and about 45% had lost half their teeth. Patients were followed for an average of 3.7 years, and major cardiovascular events (MACE, a combination of heart attack, stroke, and cardiovascular death).
They found that every increase in tooth loss category was associated with a 6% increase in MACE risk, a 17% increase in risk of cardiovascular death, a 16% increased risk of death from all causes, and a 7% increase in stroke risk.
Overall, the group with no teeth had a 27% higher risk of MACE, an 85% higher risk of cardiovascular death, 81% increased risk of death, and a 67% increase in stroke risk.
These results are after accounting for the fact that patients with more tooth loss were older, smokers, female, more likely to have diabetes, and less active.
Is Gum Disease to Blame?
Researchers note that the design of their study doesn’t let them directly attribute the increased risk to gum disease, though that is a mechanism that’s been previously established. Other possible links include the need for a soft diet, which might put people with fewer teeth at a higher risk for heart disease, genetic factors, or other links not yet illuminated.
But since we have evidence that treating gum disease helps heart disease patients–and even helps them reduce costs–it makes sense to look to gum disease as a great option for saving the lives of people with heart disease.