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Gender differences in the relationship between periodontal disease, tooth loss, and atherosclerosis
Moïse Desvarieux1, Christian Schwahn, Henry Völzke
1Division of Epidemiology, School of Public Health, University of Minnesota, USA.
Insights
Periodontal disease and tooth loss are linked to subclinical atherosclerosis in men, but not women. This suggests gender differences in cardiovascular disease risk factors may be partly explained by periodontal health.
Area of Science:
- Cardiovascular Health
- Periodontology
- Public Health
Background:
- Cardiovascular disease (CVD) disproportionately affects males.
- Males also experience a higher burden of periodontal disease.
- Existing research suggests a link between periodontal infections, tooth loss, and atherosclerosis.
Purpose of the Study:
- To investigate gender differences in the relationship between periodontal disease, tooth loss, and subclinical atherosclerosis.
- To determine if periodontal health status influences subclinical atherosclerosis differently in men and women.
Main Methods:
- 1710 participants (aged 45-75) without prior myocardial infarction or stroke were enrolled.
- Participants underwent periodontal examination and carotid artery ultrasound.
- Cardiovascular risk factors, lifestyle markers, and social network data were collected.
Main Results:
- Periodontitis severity and tooth loss increased together in both genders.
- Males showed a significant association between tooth loss, long-term periodontitis, and carotid artery plaque prevalence, unlike females.
- Gender differences in carotid plaque prevalence were more pronounced in younger individuals.
Conclusions:
- Tooth loss and chronic periodontitis are associated with subclinical atherosclerosis in men, but not women.
- These findings suggest that gender-specific risk factors, including periodontal health, may contribute to variations in cardiovascular disease.
- Understanding these gender differences can inform targeted public health strategies for CVD prevention.
Background And Purpose:
Males carry a disproportionate burden of cardiovascular disease. Because males also bear a higher burden of periodontal disease, we investigated the existence of gender differences in the postulated relationship between periodontal infections, tooth loss, and subclinical atherosclerosis.
Methods:
A total of 1710 randomly enrolled participants between the ages of 45 and 75 with no history of myocardial infarction or stroke received a clinical periodontal examination, carotid scan using high-resolution B-mode ultrasound, and extensive measurements for conventional cardiovascular risk factors (age, education, smoking, alcohol, body mass index, diabetes, systolic blood pressure, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, and triglycerides) as well as markers of healthy lifestyle and social network.
Results:
In both genders, measures of current and long-term periodontitis worsened as tooth loss increased. In males but not females, an approximately 10% difference in carotid artery plaque prevalence was observed between the lowest and highest tertiles of tooth loss (P<0.05) and long-term periodontitis (P=0.05) after multivariate adjustment. Similar patterns were observed for intima-media thickness. The influence of gender on carotid artery plaque prevalence was most evident among the younger age group (<59 years). Between genders, carotid plaque prevalence differed by 10%, 15%, and 25% across increasing levels of tooth loss, and by 5%, 15%, and 25% across increasing levels of long-term periodontitis.
Conclusions:
Our data suggest that tooth loss and long-term periodontitis are related to subclinical atherosclerosis in men but not women. Gender variations in cardiovascular morbidity or mortality may be explained partly by the differential contributions of novel risk factors across genders.
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