Once again, an oral health condition has been linked to heart disease. A new study found that dental patients with prevalent calculus ended up developing chest pain, or angina pectoris, significantly more often than patients with healthy teeth and gums.
The researchers followed thousands of patients in Sweden over 26 years. Patients with a high calculus index were significantly more likely to develop angina pectoris than those with a lower calculus index, the group concluded (PLOS One, June 23, 2016).
"This straightforward cohort study showed for the first time an interesting statistical association between high dental calculus index scores and angina pectoris," wrote co-authors Birgitta Söder, DrMedSc, PhD; Jukka Meurman, DDS, MD, PhD; and Per-Östen Söder, OdontDr, PhD.
Link between dental and coronary artery diseases
While scientific studies have repeatedly linked chronic oral infections with vascular diseases, strokes, and heart attacks, researchers had not yet studied a connection between less grave forms of the conditions. The international study authors specifically wanted to see if there was a connection between dental calculus, a sign of poor oral hygiene, and chest pain, a sign of coronary artery disease.
"Indeed, the statistical association between poor oral health and atherosclerosis is well-established," the authors wrote. "However, overall scientific evidence is still weak in this regard."
The researchers used data from a long-term study with 1,676 Swedish participants who were between the ages of 30 and 40 in 1985. The participants underwent medical and dental tests in 1985 and were followed by the Swedish hospital system for 26 years. Then, in 2011, the study participants were tested again.
After analyzing the data, the study authors found a statistically significant link between having a high calculus score in 1985 and having developed angina pectoris by 2011.
Link between dental calculus and angina
"In the multiple logistic regression analysis with angina pectoris as the dependent variable and several independent variables ... high calculus index appeared to be a principal independent predictor associated with 2.21 times the odds of angina pectoris," the authors wrote.
Participants with less education and those missing first maxillary molars were also significantly more likely to have angina pectoris. However, gingival index score, plaque index score, and the number of periodontal pockets between groups did not affect the likelihood of a participant developing chest pain.
Need for more research
The authors were most surprised that only three of their data points were significantly connected with angina pectoris.
"Namely, it was an astonishing observation that only calculus index emerged as significant explanatory factor in the regression analysis conducted," they wrote. "However, it should be emphasized that no true causality can be discussed based on this observational study."
While the study excelled at having a large participant base and a lengthy observation time, the study data did not include other angina pectoris risk factors, such as blood pressure and lipid profiles. Therefore, the researchers suggested that future studies consider looking at dental calculus at a potential link to coronary artery disease.
"In general, however, the association between calculus formation and systemic health has not been widely investigated," the authors concluded. "Hence our present results provide new insight into this partly controversial area. It is clear, however, that in future studies a more comprehensive palette of angina pectoris risk factors need to be considered than was available in the present database."
