Age, dental infections, and coronary heart disease

Epidemiological and intervention studies have suggested that infections are risk factors for coronary heart disease (CHD). Dental infections have appe ared as cardiovascular risk factors in cross-sectional and in follow-up stu dies, and the association has been independent of the "classic" coronary ri sk factors. This case-control study aimed at detailed assessment of the den tal pathology found in various CHD categories (including elderly patients). Altogether, 85 patients with proven coronary heart disease and 53 random c ontrols, matched for sex, age, geographic area, and socio-economic status, were compared with regard to dental status, assessed blindly with four sepa rate scores, and to the '"classic" coronary risk factors (seven of the cont rols had CHD, and they were not included in the analyses). The dental indic es were higher among CHD patients than in the controls, but, contrary to pr evious studies, the differences were not significant (between the CHD patie nts and their matched controls or among the different CHD categories). This result could not be explained by potential confounding factors. The partic ipants in the present study were older and had more often undergone recent dental treatment in comparison with subjects in our earlier studies. Age co rrelated with the severity of dental infections only in the random controls but not in the coronary patients who, although young, already had high den tal scores. We believe that the higher age of the participants in the prese nt study is the most likely reason for the results. Other possible explanat ions include an age-related selection bias among older CHD patients, and th e fact that those participating in studies Like this may have better genera l health and thus also less severe dental infections. Thus, the role of den tal infections as a coronary risk factor varies according to the characteri stics of the population studied.