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Could Your Smile Betray a Heart Risk?

Early study results find cardiovascular link to tooth loss

(HealthDay is the new name for HealthScoutNews.)

THURSDAY, July 31, 2003 (HealthDayNews) -- People who lose their teeth are more likely to develop the early signs of heart disease than those with a mouthful of pearly whites, a new study finds.

However, that doesn't mean that brushing your teeth can prevent a heart attack, the researchers quickly add.

A going hypothesis is that the same kind of inflammation that goes with the gum disease that causes tooth loss is happening in the arteries, says Dr. Moise Desvarieux, an assistant professor of epidemiology and medicine at the University of Minnesota. He is lead author of a paper in the Aug. 1 issue of Stroke on a trial to test that theory.

The report covers the first 711 of what are planned to be 1,050 participants. All are 55 or over and none have a history of heart disease. Desvarieux and his associates have been counting missing teeth and looking for other signs of periodontal disease, such as the deposits called plaque.

They have also been looking for a different kind of plaque -- deposits in the arteries that can build up in the carotid arteries, the vessels that feed the brain, to cause a stroke.

So far, the study seems to be favoring the theory, Desvarieux says. Of participants missing zero to nine teeth, 45 percent have carotid artery plaque. Of those with 10 to 19 missing teeth, 60 percent have a buildup of carotid artery plaque.

The researchers have checked to see whether tooth-losers are more likely to have the unhealthy lifestyle that contributes to both tooth loss and heart disease, such as smoking or diabetes. "We controlled for those factors and the relationship still existed," Desvarieux says.

They are counting lost teeth because that is a definitive way of measuring periodontal disease, he says. "The conventional method, looking around teeth, becomes impossible once a tooth is lost," he says. "There is nothing to measure."

The study is just beginning, Desvarieux stresses. The participants will be followed for at least three years to see whether they progress toward having definite arterial disease, and whether tooth loss correlates with cardiovascular events such as stroke.

Even if all that checks out, more will be needed to establish a definite relationship, says Dr Ann F. Bolger, an associate professor of medicine at the University of California at San Francisco and a spokeswoman for the American Heart Association.

"We really need to understand whether these two factors just occur together or whether there is a causal role," she says. "That would take another study. If we do prove a causal role, there would have to be a treatment study."

This latest study is part of a movement that says inflammation plays a major role in cardiovascular disease. Researchers have identified high blood levels of C-reactive protein, an inflammation-related molecule, as a risk factor for heart disease and stroke, although they are not yet certain whether there is a cause-and-effect relationship.

Desvarieux and his colleagues will be measuring blood levels of C-reactive protein and other inflammation-related molecules in the study participants to see how they correlate with the risk of stroke.

More information

You can learn all about periodontal disease from the American Academy of Periodontology. To find other risk factors for stroke, visit the American Heart Association.

SOURCES: Moise Desvarieux, M.D., assistant professor, epidemiology and medicine, University of Minnesota, Minneapolis; Ann F. Bolger, M.D., Ph.D., assistant professor, medicine, University of California, San Diego; Aug. 1, 2003, Stroke
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