Suboptimal oral health and the risk of cardiovascular disease in the presence of competing death: a data linkage analysis

Dental caries prevalence in relation to the cardiovascular diseases: cross-sectional findings from the Iranian kurdish population

OBJECTIVE

Oral and dental health (ODH) is a significant public health concern globally, affecting billions of people. This cross-sectional study aimed to examine the prevalence of dental caries using the DMFT index and investigate its relationship with cardiovascular diseases in the Iranian Kurdish population.

METHODS

A total of 3,996 individuals aged 35-70 years were included from the Dehgolan prospective cohort study (DehPCS). Clinical examinations were performed to assess decayed (DT), missing (MT) and filled (FT) teeth (DMFT index). Data on demographics, socioeconomic status, medical history, oral hygiene practices were also collected. Cardiovascular disease (CVD) history was self-reported via questionnaires assessing heart disease, heart attack and stroke. Logistic regression was used to assess associations between oral health indicators and self-reported CVD, adjusting for potential confounders.

RESULTS

The mean DMFT score was 18.18 ± 19, indicating a high oral disease burden. Specifically, 60.04% had DT, 37.82% had more than 16 MT, and 38.83% had FT. Only 13.21% reported flossing regularly and 43.17% brushed less than daily, showing suboptimal oral hygiene. The overall CVD prevalence was 9.21%. Individuals with high DMFT (≥ 14) scores had approximately two times higher CVD prevalence than those with low DMFT. DMFT decreased by 10.23% with increase in education level, and by 5.87% as economic status increased In adjusted analyses, high DMFT scores (OR = 1.5, 95%CI: 1.2-1.9) and MT (OR = 1.5, 95%CI: 1.1-2.1) were associated with 50-150% increased odds of CVD, though associations weakened after adjusting for age. Among men, DMFT remained a significant predictor for CVD after age adjustment, with an odds ratio of 2.37 (95% CI: 1.22-4.60).

CONCLUSION

This population had substantial oral disease and poor oral hygiene. Higher DMFT scores and MT positively correlated with increased CVD prevalence. Promoting preventive oral care and health education could help reduce dental issues and potentially lower CVD risk. Further research is needed to clarify biological mechanisms linking oral and systemic health.

Oral Health Clearance Outcomes for Cardiovascular Surgery

Objective

To determine the risk of morbidity and mortality in patients receiving dental extractions before planned cardiovascular surgery (CVS) and examine factors that may affect the chance of oral health clearance.

Patients and Methods

A retrospective medical record review was performed of patients who underwent dental screening before CVS from January 1, 2015, to December 31, 2021, at a major medical institution. A total of 496 patients met the inclusion criteria and were divided into 2 groups. Group 1 patients were cleared to advance to planned CVS (n=390). Group 2 patients were not cleared for surgery and subsequently underwent dental extractions before planned CVS (n=106).

Results

Six patients (5.7%) experienced postoperative complications after dental extraction that resulted in an emergency room visit. No deaths occurred after dental extraction before CVS. However, 4 patients died within 30 days of CVS, 3 from Group 1 (0.77%) and 1 from Group 2 (0.94%). Dental extraction before planned CVS showed a borderline significant association with death based on unadjusted (P=.06) and age-adjusted analysis (P=.05). Patients who reported seeing a dentist routinely had a significantly higher chance of oral health clearance (P <.001). No differences were noted between the 2 groups with regard to age, sex, or 30-day hospital readmission rate.

Conclusion

Patients who had dental extractions completed before planned CVS may be at an increased risk of mortality. Further studies are needed to examine this relationship. Emphasis should be on prioritization of routine dental visits before planned CVS.

Former Incarceration, Time Served, and Perceived Oral Health among African American Women and Men

A large body of research has documented the far-reaching health consequences of mass incarceration in the United States. Yet, less scholarship has examined the relationship between former incarceration and oral health, a key reflection of health and disease occurring within the rest of the body. Using data extracted from the National Survey of American Life (n = 3343), this study examines associations among former incarceration status, duration of detention, and self-reported oral health among African American women and men. Results from gender-stratified ordered logistic models reveal that formerly incarcerated African American men and women experience significantly poorer oral health than their never incarcerated counterparts even after controlling for important social determinants of health. Furthermore, oral health is curvilinearly associated with the length of time that men are incarcerated such that odds of poor health decrease as detention duration increases up to approximately 15 years incarcerated. After 15 years of detainment, the odds of poor health tend to increase as duration increases. Findings extend research identifying gendered spillover health consequences of contact with the criminal legal system. Health professionals and policymakers should be conscious of incarceration as an important deleterious experience for the immediate and long-term condition of people's teeth, mouth, and gums.