Self-perceived Good Fit of Removable Dental Prostheses and 19-year Follow-up of Cardiovascular Mortality

Objectives: Previously, we reported various removable dental prostheses (RDPs) were associated with varying degree of cardiovascular survival. However, the patients’ perception of the fit of RDPs on CVD mortality has not been studied.
Methods: We asked the study participants of Kuopio Oral Health and Heart study (N=506) who wore RDPs about their perception of the fit of their dental prostheses at baseline. Using proportional hazard regression methods in 476 persons with complete data, we analyzed the relationship of self-reported good fit of RDPs to CVD mortality controlling for sex, age, smoking, diabetes, hypertension, total/HDL cholesterol ratio, and education.
Results: After 18.8-year median follow-up, 94 CVD mortalities were accrued. For maxillary RDPs, 155 reported good fit and 93 reported fair/poor fit. For mandibular RDPs, 83 reported good fit and 79 reported fair/poor fit. We divided the cohort into 4 groups: Referent group: RDP non-wearers (N=223); group1: reporting both arches or one arch opposing natural dentition fitting well (N=120); group2: reporting good fit in one arch and bad fit in other (N=47); group3: both arches fit poorly (N= 88). In multivariate analyses, the hazard ratios (HR) for CVD mortality for groups 1, 2, and 3 compared with non-RDP wearers were 1.60 (p=0.09), 1.73 (p=0.11), and 1.02 (p=0.95). Thus, patients’ perception of good fit of RDPs appeared to be associated with increased risk for CVD mortality, although it was not significant. Furthermore, non-parametric Kruskal-Wallis Tests revealed potential inflammatory markers that may explain the differences, where age, oral infection score, serum-CRP levels, salivary-IgA, salivary-amylase, and salivary-yeast levels were significantly higher, while the number of teeth, salivary-IgG, salivary-MMP-8, salivary-albumin were significantly lower in the group reporting good-fit. Salivary-lysozyme or salivary-urea was not significantly different.
Conclusions: Self-perception of good fit of RDPs which may lead to dental neglect and increased oral inflammation was associated with increased the risk of CVD mortality.