Tooth scaling reduces CV disease risk

By Sarah Guy

Taiwanese study results show that undergoing tooth scaling significantly reduces the risk for future myocardial infarction, stroke, and total cardiovascular (CV) events.

The findings also reveal that increasing the frequency of tooth scaling could further reduce the risk for these CV disease-related events.

"Poor oral hygiene is the major cause of periodontal disease," say the researchers in the American Journal of Medicine, "...periodontal disease has been reported to be associated with an increased risk for CV disease, peripheral vascular disease, and stroke."

They add that their data "support tooth scaling in addition to daily tooth brushing to improve oral hygiene and reduce the risk of CV disease."

Hsin-Bang Leu (Taipei Veterans General Hospital) and colleagues selected study participants aged at least 50 years from the Taiwanese National Health Insurance (NHI) program to investigate the impact of tooth scaling on CV disease and stroke risk.

All NHI participants are eligible for yearly tooth scaling, note the researchers.

In the current study, Leu and co-workers included 21,876 NHI participants, of whom 10,887 had received full-mouth or localized tooth scaling during the period 1995 to 2007. This exposed group was propensity-score matched to a nonexposed group (n=10,989) that had not undergone any scaling.

After an average 7-year follow up, the nonexposed group had a significantly higher incidence of acute myocardial infarction than the exposed group, at 2.2% versus 1.8%, and the same trend was found for incidence of stroke, at 10.0% versus 9.4%.

In multivariate analysis, adjusted for factors including age, gender, hypertension, and Type 2 diabetes, tooth scaling was significantly independently associated with a 31% reduced risk for myocardial infarction, a 15% reduced risk for stroke, and a 16% reduced risk for composite CV events, report Leu et al.

Furthermore, they write, the hazard ratio for experiencing a myocardial infarction during the follow-up period was 0.61 for participants who had undergone tooth scaling more than once every 2 years compared with those in the nonexposed group.

Frequency of scaling also had the same association for stroke and total CV risk.

There are "many proposed mechanisms" to explain the relationship between periodontal disease and CV disease, remark Leu and team. The increase in inflammation and subsequent effect on circulating cytokines as a result of the infection would increase atherosclerosis, for example.

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