Oral Health Linked to Obstructive Coronary Heart Disease in Cross-Sectional Study

Abstract

Background:

Coronary artery disease (CAD) is a principal source of cardiovascular illness and death globally. Various risk factors contribute to an increased risk of CAD. Growing evidence proposes that inflammation may contribute in promoting acute thromboembolic events in susceptible individuals. Oral health, encompassing dental and periodontal health, is a significant public health concern affecting individuals throughout their lifespan. Existing literature indicates potential shared multifactorial etiologies between dental/periodontal health and CAD. This work aimed to inspect the link between oral hygiene (dental health and periodontal health) and CAD confirmed by coronary angiography.

Materials and methods:

This single-center study recruited 118 patients from the Shahid al-Mihrab Center for Interventional Cardiology. All participants were diagnosed with CAD and scheduled for coronary angiography by cardiologists. Blood tests were performed upon admission to assess creatinine, urea, and white blood cell (WBC) counts using standard methods.

Dental health was estimated using the specific index of “Decayed, Missing, Filled Teeth (DMFT)”. Periodontal health was assessed based on clinical attachment loss (CAL), defined as the space between the cement-enamel zone and the junctional epithelial attachment. The analysis of variance (ANOVA) employed to inspect continuous variables, while the chi-square test was used to inspect the categorical variables. Descriptive data included the mean and standard deviation to present continuous variables and frequency and percentage present categorical parameters. A p-value less than 0.05 was measured as significant.

Results:

The study population with CAD exhibited poor periodontal health, with 90.7% presenting with localized or generalized periodontitis, half of which were moderate-to-severe cases. Similarly, poor dental health was evident, reflected by a high overall DMFT index (14.6 ± 4.7). Approximately two-thirds of the patients had a DMFT score exceeding 9, indicating a loss of two-thirds of their total dentition. A statistically significant direct association (p=0.004) was observed between dental status and number of critical coronary arterial stenosis. Additionally, a strong direct association (p=0.003) was exposed between the severity of periodontitis and the number of critical coronary arteries stenosis. The association between stages of periodontitis and the number of critically stenosed coronary arteries was positive but not significant (p > 0.05).

Conclusions:

This study reveals an association between oral health (dental and periodontal health) and obstructive CAD in patients undergoing coronary angiography. A significant strong correlation was identified between dental status and periodontitis severity with the occluded coronary arteries. The association between stages of periodontitis and the number of critical stenosis was positive but not statistically significant.