Odontogenic Infections and Death Caused by CVD: a Post-Mortem Study

Objective: To examine if subjects who have died of cardiovascular diseases (CVD) express more signs of infections of dental origin than subjects who have died of other reasons. Methods: Clinical, radiological and microbiological data were collected in context with a forensic autopsy. The radiographic examination of the subjects was made using panoramic radiography. The clinical intraoral and dental status of the deceased including periodontal attachment level of the teeth was recorded. A pooled subgingival bacterial sample was taken from deep periodontal pockets for culture and microbiological analysis. Results: The mean age of the study subjects (n=26, all male) was 58.4 years (SD 9.1, range 50-75). The study subjects had more signs of experienced odontogenic infections as expressed in number of missing teeth, DMFS, number of teeth treated endodontically, and number of periodontal pockets exceeding 4 mm in depth. Presence of Actinobacillus actinomycetemcomitans in the subgingival plaque samples collected from deep periodontal pockets could not be ensured. Porphyromonas gingivalis (P.g.) was detected in 53% of the studied samples. The mean proportion of P.g. was 1.6% (range 0,07-10%). Prevotella intermedia/nigrescens was detected in 67 % of the samples with a mean proportion of 1.3 % (range 0.01-5%). Other detected potential periodontal pathogens were Tannerella forsythensis (20% of samples, mean proportion 0.35%, range 0.02-1%), Peptostreptococcus micros (33% of samples, mean proportion 3.0%, range 0.2-10%) and Campylobacter rectus (33% of samples, mean proportion 2.3% range 0.2-10%). Conclusion: The oral health of the subjects who died of CVD seems to be inferior to that of those who have deceased of other reasons. Potent periodontal pathogens can be cultivated from subgingival plaque samples of subjects who have died of cardiovascular diseases. The limited data collected at present does not warrant any definite conclusions of the clinical relevance of these findings.