Cardiovascular Mortality is Reduced by Endodontic Care

Methods: The Kuopio Oral Health and Heart study was a case-control study (256 CAD cases and 250 controls, mean age=60) with data collection in 1995. We have linked subsequent CVD mortality status to these baseline data to achieve a 15-year longitudinal follow-up. The relationship between radiographic evidence of endoTx on cardiovascular mortality was examined by proportional hazard regression analyses adjusting for age, sex and smoking, diabetes, hypertension, total/HDL cholesterol ratio and education. As endoTx may be dependent on the number of teeth present (NT), we also adjusted for this confounding variable. We also undertook subgroup analyses stratified by Coronary Artery Disease (CAD) or dentate status.

Results: In the fully adjusted multivariate model, those who received at least 1 endoTx demonstrated a 67% improvement in CVD survival compared with those who did not. [Hazard ratio (HR) 0.33, 95% confidence interval (CI): 0.14 - 0.75 P=0.009. With additional adjustment for NT, endoTx was still protective against cardiovascular mortality [HR 0.45 CI 0.22 - 0.93 P=0.03. Subgroups who had CAD at baseline or the dentate group also demonstrated beneficial trends of endoTx with HR =0.48 CI: 0.18 - 1.30 P=0.15 and HR 0.49 CI:0.22 - 1.03 P=0.06, respectively.

 Conclusions: In this age 60 and older population, those who had had endodontic treatment that had eliminated periapical inflammation at baseline had a 67% improvement in cardiovascular survival at 15- years follow-up. There was also a non-significant trend for those who had both CAD at baseline and endodontic treatment for improved CVD survival.  Future larger studies are warranted.