Dental Health, Cardiovascular Disease and Inflammation in Adults and Children

Objectives: A growing body of epidemiologic evidence links oral health, periodontal disease, and cardiovascular health. While underlying pathophysiologic mechanisms are unclear, several studies have suggested a chronic, sub-acute inflammatory state, also implicated in the pathogenesis and etiology of cardiovascular disease. The objective of this study was to evaluate the relationship between self-reported dental health practices, oral health and cardiovascular disease risk factors, including inflammation, in children and adults in rural communities. Methods: 190 participants in a community-based study completed a health screening that included anthropometric assessments (height, weight, blood pressure, hip and waist circumference etc.), collection of blood and saliva specimens, and a series of questionnaires about lifestyle habits, psychosocial health, and oral and dental health. Using multi-plexed assay technology, multiple inflammatory markers were obtained from plasma samples. Results: Participants - adults or parents of child participants - were nearly equally split on rating their overall dental health as good or better (47.6%) or fair or poorer (52.4%). Regarding dental health practices, 39.2% of adults reported not flossing regularly, and 39.3% of parents reported their children not flossing regularly. In children, parental rating of oral health was associated with altered levels of EGF, haptoglobin, IL-6, IL-8, MIP-1a, and sVCAM (p<0.05), and marginally related to altered levels of adiponectin, amylin, sE-Selectin, and VEGF (p<0.1). In adults, flossing habits were related to 10 year Framingham Risk Score (LDL, total cholesterol), GLP-1, IL-1ra, IL-8, and tPAI-1 (p<0.05), and marginally related to altered levels of IL-6, IL-1a, glucagon, systolic blood pressure, and HDL cholesterol (p<0.1). In children, IL-1b was marginally associated with flossing habits (p<0.1). Conclusions: This study suggests a relationship between dental health and inflammation and cardiovascular disease risk in both children and adults. Further study is needed to better understand underlying pathophysiologic processes, and the interactions with psychosocial, behavioral, and socioeconomic mediators of health.