Date of Award

Spring 2015

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Health and Kinesiology

First Advisor

Gerald Hyner

Committee Chair

Gerald Hyner

Committee Member 1

Frank Snyder

Committee Member 2

Roseann Lyle

Abstract

The association between oral health and cardiovascular disease (CVD) has been under vigorous investigation during the last decades. Consensus documents have stated the independent relationship between periodontal disease and subsequent tooth loss and CVD. Associations between tooth loss and chronic coronary heart disease (CHD), myocardial infarction (MI), and stroke have not been evaluated separately in a single nationwide cohort. This cross-sectional study used self-reported data from the Behavioral Risk Factor Surveillance System 2012 and was conducted to evaluate the association between the number of teeth lost due to caries or periodontal disease and the prevalence of CVD. The final cohort of 260,610 subjects consisted of persons 45 years of age and older; 41.50% of whom were 65 years old or older, 58.34% were female, and 81.86% were White. Logistic regression models were built separately for chronic CHD, MI, and stroke. After adjusting for age, race/ethnicity, sex, income, body mass index, diabetes, smoking status, alcohol usage, and diagnosis of another CVD, all models revealed a significant association between the number of teeth lost and the prevalence of chronic CHD, MI, and stroke. Although significant associations were present for the subjects who had lost 1-5 teeth, 6-31 teeth, and all teeth; the associations were the strongest in the latter group, where for chronic CHD AOR = 1.44, 95% CI [1.28, 1.63], for MI AOR = 1.86, 95% CI [1.66, 2.10], and for stroke AOR = 1.46, 95% CI [1.29, 1.66]. Further adjustment for health insurance availability and dental care usage did not change the outcome. Subgroup analysis revealed similar outcomes for both sexes. Predictive associations were most significant in the range of 45-64 years of age. Tooth loss was independently associated with the prevalence of chronic CHD, MI, and stroke among people 45 years of age and older. The number of teeth lost could be used as an additional marker of an elevated cardiovascular risk in this age group.

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