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Losing Teeth When Middle-Aged May Mean Higher Risk of Cardiovascular Disease

Losing two or more teeth during middle age may mean an increased risk of heart disease, according to research performed by the Tulane University School of Public Health and Tropical Medicine and Harvard T.H. Chan School of Public Health.

The research, presented at the American Heart Association’s Epidemiology and Prevention | Lifestyle and Cardiometabolic Health Scientific Sessions 2018, expands on earlier studies regarding the connection between oral health and cardiovascular concerns.

“Periodontal infections, inflammation and other dental health problems and their connections to cardiovascular conditions have been studied for many years,” said Dr. Stefania Caracioni, D.D.S., L.V.I.F., a Topeka dentist.

Earlier research has connected dental health issues with an increased risk of cardiovascular disease, but previous studies that looked at tooth loss considered tooth loss over a lifetime, versus a specific period like middle age.

What is notable about looking tooth loss in middle age?

“For many people, tooth loss that occurs during middle age is a result of inflammation and periodontal disease, compared to the causes of tooth loss when you’re younger: trauma, tooth decay and orthodontic treatment,” Caracioni said.

Periodontal disease causes cardiovascular issues because the presence of disease-causing bacteria triggers the body’s natural response to inflammation. Prolonged periods of inflammation can cause damage to tissues of the body, including the heart and blood vessels.

“In addition to damage caused by inflammation, the bacteria found in periodontal infections can also travel through the bloodstream to the heart and infect the heart muscle,” Caracioni said.

The study authors took a closer look at how and why tooth loss in middle age increases heart disease risk.

The study investigated the connection by analyzing information collected during studies of adults, between 45 and 69, where participants reported how many teeth they had. The study participants also took a follow-up survey regarding recent tooth loss.

Adults who participated in the studies analyzed by Tulane did not have cardiovascular issue when their respective studies began. The Tulane study authors examined the occurrence of tooth loss over an eight-year span. They then looked for the presence of cardiovascular issues in adults who experienced no tooth loss, lost one tooth or loss two or more teeth.

Their finding revealed that adults who had 25 to 32 natural teeth at the beginning of the study had a 23 percent higher risk of cardiovascular health problems in comparison to adults with no tooth loss. The risk of cardiovascular health problems increased 16 percent among all participants, regardless of how many teeth they had at the beginning of the study.

The increased risk was independent of changes in diet, physical activity level and increased body weight. The risk was also independent of the presence of negative cardiovascular health factors such as high blood pressure, diabetes and high cholesterol and diabetes.

Adults who had less than 17 natural teeth at the beginning of the study had a 25 percent greater risk of developing cardiovascular problems.

There was not a notable increase in cardiovascular disease risk for participants who lost one tooth during the study.

Tooth loss during middle age does not just impact the heart; tooth loss can also affect the rest of an individual’s health, too.

“Losing teeth can make eating difficult, which translates to changing diets to softer foods which may not be healthy or enough to sustain the body,” Caracioni said.

Consequently, patients with missing teeth often lose weight, develop health conditions such as diabetes and may even face the loss of additional teeth.

Tooth loss can also cause changes in speech, increase depression and anxiety and change how individuals socialize.

“Tooth loss has a significant impact well beyond the appearance of a person’s smile,” Caracioni said.


American Heart Association. “Middle-aged tooth loss linked to increased coronary heart disease risk.” ScienceDaily. ScienceDaily, 21 March 2018.

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