Examining the link between coronary heart disease and the elimination of chronic dental infections

Background. While it has been suggested that periodontal disease may be ass ociated with coronary heart disease, or CHD, there are no data to suggest t hat the elimination of chronic dental infections actually lowers the risk o f developing chronic CHD. The goal of this study was to determine whether p eople with a definitive elimination of all potential dental infections-eden tulous people, who are at the optimum endpoint of dental infection eliminat ion from a CHD perspective-lower their CHD risk over time when compared wit h people who have a specific dental infection, periodontitis. Methods. The authors examined data from a prospective cohort of 4,027 peopl e who participated in the First National Health and Nutrition Examination S urvey, or NHANES I, Epidemiologic Follow-up Study. The primary outcome meas ure was the first CHD event. Results. During a mean follow-up of 17 years, there were 1,238 CHD events ( 538 fatal). The confirmed elimination of chronic dental infections did not lead to a decreased risk of experiencing a CHD event (relative risk, 1.02; 95 percent confidence interval, 0.86-1.21). The CHD risk among people with and without chronic dental infections remained constant over time with resp ect to each other (test for increasing or decreasing trend over time: not s ignificant, chi (2)(1) = 0.48; P = .93). Conclusions. People who had a complete, definitive and long-term eliminatio n of all potential dental infections through extraction of all teeth did no t have lower CHD risk when compared with people with diagnosed periodontiti s. Clinical implications. Until evidence is found to the contrary, the authors suggest that prevention of CHD should not be used as the basis for recomme nding treatment to eliminate chronic dental infections.