Is apical periodontitis a risk-factor for prevalent or incident coronary-heart-disease?

Objectives: To investigate apical periodontitis (AP) as a risk factor for prevalent and incident coronary heart disease (CHD) events in a group of middle-aged men from Northern Ireland.

Methods: A representative sample of 1362 dentate men, aged between 58 and 72 years, had a comprehensive dental examination between 2001 and 2003. CHD events were validated by independent cardiologists. Periapical status was assessed from dental orthopantomograms using the periapical index. Men with AP were categorised as high ( > 3teeth with AP) or low ( < 3 teeth with AP). A cross sectional analysis was performed at baseline, the time of their dental examination, to explore associations between AP and prevalent CHD in men who were CHD free at the beginning of the study and were followed-up until 2015 to investigate a potential association between AP and incident CHD. The chi square test was used.

Results: The mean age of the men at baseline was 64.2 (SD 2.9) years. Of the 1362 men examined, 121 (8.9%)had prevalent CHD. The men who had prevalent CHD had fewer teeth (p = 0.01), were less likely to have ever smoked (p < 0.01) and had higher periodontal attachment loss (p < 0.01), compared to those who had not experienced a CHD event. In the high AP group 38 (10.5%) of 363 men had a prevalent CHD event compared to83 (8.3%) of the 999 in the low AP group, p = 0.22. During a median follow-up of 12.7 (IQR 10.6-13.3) years, 134(10.8%) of the 1241 men free of CHD at baseline had an incident event: 35 (10.8%) of 325 men in the high AP group had a CHD event compared with 99 (10.8%) of 916 men in the low AP group, p=0.99.

Conclusions: In this group of dentate men, AP was not associated with prevalent or incident CHD.