Statin use and tooth loss in chronic periodontitis patients

Objectives: Statins are a group of lipid lowering drugs that are widely used to lower cholesterol levels and the risk of cardiovascular events. Statins have pleiotropic effects including anti-inflammatory properties and there is some evidence of health benefits beyond cardiovascular diseases. The goal of this study was to evaluate whether statin use in chronic periodontitis patients had a beneficial impact on tooth loss. Methods: Dentate adults of the Kaiser Permanente Dental Care Program (n=1,021) were followed for tooth loss during a mean period of 7 years. The dental records were merged with a prescription database and utilization of statins was quantified in terms of duration of use. Tooth loss rates were estimated using Poisson regression models, adjusting for age, gender, baseline disease severity, prior and actual periodontal treatment, and caries activity and dental attitude proxies. Results: Statin use at any time during the study period (n=103) was associated with 87% (RR=1.87; 95%CI 1.20-2.92) increased risk of tooth loss. When statin use was modeled as a time-dependent covariate, a non-significant increase in tooth mortality rate of 41% (RR=1.41; 95%CI 0.80-2.50) was associated with each year of statin use. Conclusions: Statin use was associated with an increased, not decreased, risk of tooth loss in chronic periodontitis patients. While we can not exclude the possibility that the observed effect is due to statin use, more likely explanations are that factors associated with statin use and not measured in this study, such as smoking, diabetes, or hyperlipidemia are the causes of the observed increased tooth loss. NIDCR 1 R21 DE015619 and Capes-Brazil.