Patients with more frequent caries may be more likely to have cardiovascular disease, even when risk factors like age and smoking are considered. This study was published recently in Frontiers in Oral Health.
Therefore, the decayed, missing, and filled teeth (DMFT) index may be a useful tool for predicting cardiovascular disease risk, the authors wrote.
“Our results show that participants with higher occurrence of dental caries are more likely to have a history of cardiovascular disease independently of traditional risk factors and confounders,” wrote the authors, led by Dr. Mariana Bezamat, PhD, of the University of Pittsburgh School of Dental Medicine (Front Oral Health, October 12, 2025, Vol. 6, 1571148).
While many studies have linked periodontitis to other systemic conditions, including cardiovascular disease and cardiovascular-kidney-metabolic syndrome, fewer have examined the relationship between caries and heart disease. This cross-sectional study aimed to investigate whether quantitative measures of caries are independently associated with cardiovascular disease, the researchers wrote.
The study used data from the Dental Registry and DNA Repository (DRDR) with 2,247 participants and the U.S. National Health and Nutrition Examination Survey (NHANES) with 3,202 participants. The DRDR measured dental caries using the DMFT index and decayed, missing, or filled surfaces (DMFS) scores. The NHANES dataset provided details on the condition of each tooth, as well as smoking habits and demographic information.
In the DRDR dataset, logistic regression showed a borderline but not statistically significant association between cardiovascular disease and DMFT after adjusting for risk factors and multiple testing (p = 0.044). However, the DRDR’s DMFS scores were significantly associated with cardiovascular disease after controlling for covariates (p = 0.006), they wrote.
In the NHANES dataset, the association between cardiovascular disease and the DMFT index remained significant after accounting for all risk factors (p < 0.0005). Overall, participants with cardiovascular disease had higher DMFT values in both datasets.
Nevertheless, the study had limitations. The survey-based data may be unreliable, as patients might have forgotten certain conditions or misreported the severity of their diseases, the authors added.
“For future validation of these results, an integration between dental and medical databases are recommended, the creation of an integrated electronic health record system would be impactful in allowing for an expansion of research focusing on the bidirectionality of oral-systemic health relationships,” Bezamat and her colleagues wrote.
