Apical Periodontitis and All-Cause Mortality Among 60-70 Year-Old Men

Objectives: To determine whether apical periodontitis (AP) was predictive of all-cause mortality in a cohort of 60-70 year-old men In Northern Ireland enrolled in the Prospective Epidemiological Study of Myocardial Infarction (PRIME) study.
Methods: The periapical status was assessed from dental orthopantomograms (OPT) using the periapical index (PAI; Ørstavik et al. 1986). A PAI score of 3-5 was equated with AP. Men with AP were divided into a HIGH (> 25% readable teeth with AP) and a LOW (<25% readable teeth with AP) group. Logistic regression was used to calculate odds ratios (OR).
Results: The average age of the 1361 men at the baseline was 64.2 (SD 2.9) years, and 441 (32.4%) died during 15.4 (SD 4.1) years of follow-up. There were 152 men with HIGH AP related to teeth that had not been root filled and they had on average 3.2 (SD 1.6) such teeth with AP. 69 (45.4%) of these men died compared with 372 (30.8%) of 1208 men in the LOW AP group, Chi-square = 13.13, p=0.0003. The unadjusted OR for a man in the HIGH AP group to have died compared with the LOW group was 1.87 (95% CI 1.33-2.63). The OR attenuated to 1.61 (95% CI 1.11-2.34), p=0.012 after adjustment for age, smoking, body mass index (BMI), Socio-economic status (SES), education status and pattern of dental attendance. The comparable unadjusted OR for root filled teeth was 1.40 (95% CI 0.57-3.46), p=0.46.
Conclusions: The men in this prospective study with high levels of apical periodontitis related to teeth that were not root filled were at an increased risk of death.