A Weighted Composite of Endodontic Inflammatory Disease is Linked to a First Myocardial Infarction

Oral Health Prev Dent. 2023 Nov 2:21:375-382. doi: 10.3290/j.ohpd.b4586815.

Abstract

Purpose: To explore a weighted composite of endodontic inflammatory disease (EID) as a risk factor for suffering a first myocardial infarction (MI).

Materials and methods: Seven tooth-specific conditions related to EID were assessed radiographically in 797 patients suffering a first MI and 796 controls. A weighted composite of EID was calculated as the sum of all teeth, excluding third molars. Using maximum likelihood estimation, each condition was assigned a specific weight. With multivariable conditional regression, EID variables, periodontal disease, and missing teeth were assessed as predictors of a first MI.

Results: Periodontal disease (OR 1.38; 95% CI 1.13-1.69, p = 0.0016) and missing teeth (OR 1.03; 95% CI 1.002-1.05, p = 0.034) were related to the risk of a first MI, while none of the EID-related conditions individually were. However, when assessed as an aggregate, a weighted composite of EID (OR 1.97; 95% CI 1.23-3.17, p = 0.0050) and periodontal disease (OR 1.34; 95% CI 1.09-1.63, p = 0.0046) was associated with the risk of MI. Missing teeth did not remain a statistically significant predictor of MI in the final model.

Conclusions: A weighted composite of EID was associated with the risk of MI and strengthens the evidence for a direct connection between oral inflammatory diseases and cardiovascular disorders.

Keywords: cardiovascular disease(s); endodontics; inflammation; periodontal disease(s); risk factors(s); systemic health/disease.

MeSH terms

  • Humans
  • Myocardial Infarction* / complications
  • Periodontal Diseases* / complications
  • Risk Factors
  • Tooth Loss*

Grants and funding

The study was supported by generous grants from the European Society of Endodontology as well as funding from Västra Götalandsregionen, Public Dental Health, Sweden, and University of Gothenburg, Sweden. This research was possible thanks to a collaboration with the PAROKRANK steering committee, Karolinska Institutet, Solna, Sweden. A special thanks to Professor Lars Rydén and Professor Björn Klinge from the PAROKRANK steering committee for valuable input to the manuscript.