Oral Health and Cardiovascular Disease: Mapping Clinical Heterogeneity and Methodological Gaps.

Area of Science:

• Public Health
• Epidemiology
• Cardiology

Background:

• Extensive research over 25 years links poor oral health to cardiovascular disease (CVD).
• The field is broad and heterogeneous, hindering comprehension and identification of research gaps.
• Existing studies present challenges in understanding implications and tracking methodological limitations.

Purpose of the Study:

• To systematically map clinical heterogeneity in studies of oral health and CVD.
• To identify methodological gaps in the research assessing the relationship between oral health and CVD outcomes.

Main Methods:

• A systematic mapping review was conducted.
• Searched Medline, Embase, and Cochrane Library for longitudinal studies on oral health and CVD outcomes.
• Extracted data on clinical heterogeneity (participant characteristics, exposure/outcome measures, follow-up) and methodological gaps (RCTs, time-varying exposures, propensity methods, mediation, competing risks).

Main Results:

• Eighty-five studies met inclusion criteria, revealing significant clinical heterogeneity.
• Inconsistent definitions for oral health indicators and CVD outcomes were common, with many studies having unclear CVD outcome definitions.
• No randomized controlled trials were found; advanced methods like propensity methods, mediation analysis, and competing risks analysis were infrequently used.

Conclusions:

• A universal conceptual framework is needed for consistent definitions of oral health and CVD outcomes.
• Emerging research methodologies should be adopted to enhance the impact of studies in this field.
• Minimizing clinical heterogeneity and addressing methodological gaps are crucial for advancing the understanding of oral health and CVD associations.