Periodontitis and edentulism as risk indicators for mortality: Results from a prospective cohort study with 20 years of follow-up

Aim To investigate the association between periodontitis and edentulism with cardiovascular disease (CVD) and all-cause mortality. Methods Baseline data of 506 subjects including 256 angiographically verified coronary artery disease patients and 250 matched participants in cardiovascular health from the Kuopio Oral Health and Heart study were collected from 1995-1996. Mortality data were accrued until May 31, 2015, and related to baseline periodontal health and edentulism, assessed as exposure and collected by means of clinical and radiographic examination by a single examiner. Cox proportional hazards regression models were fit using covariates such as age, gender, smoking, BMI, and education. The final sample size for the periodontitis models ranged from 358 to 376, while the edentate models included 413 to 503 subjects for CVD and all-cause mortality, respectively with no missing values in the predictor, confounders, and outcome. Results The strongest association was found between edentulism and CVD and all-cause mortality (HR: 1.9 (CVD), HR: 1.6(all-cause); p < .01). Conclusions Edentulism considered as a poor oral health marker was associated strongly with CVD mortality while periodontitis was not.