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Periodontitis in older Swedish individuals fails to predict mortality

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Abstract

Objectives

This study aims to assess mortality risk and its association to health aspects in dentate individuals 60 years of age and older.

Materials and methods

Medical and periodontal data from 870 dentate individuals (age range 60–96) participating in the Swedish National Study on Aging and Care in Blekinge (SNAC-Blekinge) with survival statistics over 6 years were studied.

Results

During 6 years of follow-up, 42/474 of the individuals (8.9 %), who at baseline were between age 60 and 75, and 134/396 individuals of the individuals (33.9 %), who at baseline were ≥75 years, died. Surviving dentate individuals had more teeth (mean 19.3, S.D. ± 7.9) than those who died (mean 15.9, S.D. ± 7.3; mean diff 3,3; S.E. mean diff 0.7; 95 % CI 2.0, 4.6; p = 0.001). A self-reported history of high blood pressure (F = 15.0, p < 0.001), heart failure (F = 24.5, p < 0.001, observed power = 0.99), older age (F = 34.7, p < 0.001), male gender (F = 6.3, p < 0.01), serum HbA1c with 6.5 % as cutoff level (F = 9.3, p = 0.002) were factors associated with mortality. A medical diagnosis of heart disease, diabetes, any form of cancer, or periodontitis failed to predict mortality.

Conclusions

A self-reported history of angina pectoris, chronic heart failure, elevated serum HbA1c, and few remaining teeth were associated with mortality risk. A professional diagnosis of cardiovascular disease, diabetes, cancer, or periodontitis was not predictive of mortality.

Clinical relevance

Self-health reports are important to observe in the assessment of disease and survival in older individual.

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References

  1. Kivimäki M, Tabak AG, Batty GD et al (2010) Incremental predictive value of adding past blood pressure measurements to the Framingham hypertension risk equation: the Whitehall II Study. Hypertension 55:1058–1062

    Article  PubMed Central  PubMed  Google Scholar 

  2. Taylor JJ, Preshaw PM, Lalla E (2013) A review of the evidence for pathogenic mechanisms that may link periodontitis and diabetes. J Clin Periodontol 40(Suppl 1):S113–S134

    PubMed  Google Scholar 

  3. Fowkes FG, Rudan D, Rudan I (2013) Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet. doi:10.1016/S0140-6736(13)61249-0

    PubMed  Google Scholar 

  4. Dietrich T, Sharma P, Walter C, Weston P, Beck J (2013) The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease. J Periodontol 84(4 Suppl):S70–S84

    PubMed  Google Scholar 

  5. DeStefano F, Anda RF, Kahn HS, Williamson DF, Russell CM (1993) Dental disease and risk of coronary heart disease and mortality. Br Med J 306:688–691

    Article  Google Scholar 

  6. Beck J, Garcia R, Heiss G, Vokonas PS, Offenbacher S (1996) Periodontal disease and cardiovascular disease. J Periodontol 67(10 Suppl):1123–1137

    Article  PubMed  Google Scholar 

  7. Beck JD, Elter JR, Heiss G, Couper D, Mauriello SM, Offenbacher S (2001) Relationship of periodontal disease to carotid artery intima-media wall thickness: the atherosclerosis risk in communities (ARIC) study. Arterioscler Thromb Vasc Biol 21:1816–1822

    Article  PubMed  Google Scholar 

  8. Persson RE, Hollender LG, Powell VL, MacEntee M, Wyatt CC, Kiyak HA, Persson GR (2002) Assessment of periodontal conditions and systemic disease in older individuals. II. Focus on cardiovascular diseases. J Clin Periodontol 29:803–810

    Article  PubMed  Google Scholar 

  9. Persson GR, Ohlsson O, Pettersson T, Renvert S (2003) Chronic periodontitis, a significant relationship with acute myocardial infarction. Eur Heart J 24:2108–2115

    Article  Google Scholar 

  10. Engebretson SP, Lamster IB, Elkind MS (2005) Radiographic measures of chronic periodontitis and carotid artery plaque. Stroke 36:561–566

    Article  PubMed Central  PubMed  Google Scholar 

  11. Buhlin K, Hultin M, Norderyd O, Persson L et al (2009) Risk factors for atherosclerosis in cases with severe periodontitis. J Clin Periodontol 36:541–554

    Article  PubMed  Google Scholar 

  12. Romagna C, Dufour L, Troisgros O et al (2012) Periodontal disease: a new factor associated with the presence of multiple complex coronary lesions. J Clin Periodontol 39:38–44

    Article  PubMed  Google Scholar 

  13. Soto-Barreras U, Olvera-Rubio JO, Loyola-Rodriguez JP et al (2014) Peripheral arterial disease associated with caries and periodontal disease. J Periodontol. doi:10.1902/jop.2012.120051

    Google Scholar 

  14. Tonetti MS, Van Dyke TE, on behalf of working group 1 of the joint EFP/AAP workshop (2013) Periodontitis and atherosclerotic cardiovascular disease: consensus report of the Joint EFP/AAPWorkshop on Periodontitis and Systemic Diseases. J Periodontol 84(4 Suppl):S24–S29

    PubMed  Google Scholar 

  15. Lockhart PB, Bolger AF, Papapanou PN et al (2012) Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association? A scientific statement from the American Heart Association. Circulation 125:2520–2544

    Article  PubMed  Google Scholar 

  16. Marchetti E, Monaco A, Procaccini L, Mummolo S, Gatto R, Tetè S, Baldini A, Tecco S, Marzo G (2012) Periodontal disease: the influence of metabolic syndrome. Nutr Metabol 9:88. doi:10.1186/1743-7075-9-88

    Article  Google Scholar 

  17. Southerland JH, Moss K, Taylor GW, Beck JD, Pankow J, Gangula PR, Offenbacher S (2012) Periodontitis and diabetes associations with measures of atherosclerosis and CHD. Atheroscler 222:196–201

    Article  Google Scholar 

  18. Kshirsagar AV, Craig RG, Moss KL et al (2009) Periodontal disease adversely affects the survival of patients with end-stage renal disease. Kidney Int 75:746–751

    Article  PubMed  Google Scholar 

  19. Linden GJ, Linden K, Yarnell J, Evans A, Kee F, Patterson CC (2012) All-cause mortality and periodontitis in 60-70-year-old men: a prospective cohort study. J Clin Periodontol 39:940–946

    Article  PubMed  Google Scholar 

  20. Desvarieux M, Schwahn C, Völzke H et al (2004) Gender differences in the relationship between periodontal disease, tooth loss, and atherosclerosis. Stroke 35:2029–2035

    Article  PubMed  Google Scholar 

  21. Ajwani S, Mattila KJ, Tilvis RS, Ainamo A (2003) Periodontal disease and mortality in an aged population. Spec Care Dent 23:125–130

    Article  Google Scholar 

  22. Fardal O, Fardal P, Persson GR (in press) Periodontal- and general health in long-term periodontal maintenance patients treated in a Norwegian private practice. A descriptive report from a compliant and partially compliant survivor population. J Periodontol doi:10.1902/jop.2012.120416

  23. Avlund K, Schultz-Larsen K, Krustrup U, Christiansen N, Holm-Pedersen P (2009) Effect of inflammation in the periodontium in early old age on mortality at 21- year follow-up. J Am Geriatr Soc 57:1206–1212

    Article  PubMed  Google Scholar 

  24. Fagerström C, Palmqvist R, Carlsson J, Hellström Y (2011) Malnutrition and cognitive impairment among people 60 years of age and above living in regular housing and in special housing in Sweden: a population-based cohort study. Int J Nurs Stud 48:863–871

    Article  PubMed  Google Scholar 

  25. Persson GR, Berglund J, Persson RE, Renvert S (2011) Prediction of hip and hand fractures in older persons with or without a diagnosis of periodontitis. Bone 48:552–556

    Article  PubMed  Google Scholar 

  26. Lindström V, Andersson K, Lintrup M, Holst G, Berglund J (2012) Prevalence of sleep problems and pain among the elderly in Sweden. J Nutr Health Aging 16:180–183

    Article  PubMed  Google Scholar 

  27. Agüero F, Dégano IR, Subirana et al (2013) Impact of a partial smoke-free legislation on myocardial infarction incidence, mortality and case-fatality in a population-based registry: The REGICOR Study. PLoS One, e53722 doi: 10.1371/journal.pone.0053722

  28. Lim LS (2013) Review: general health checks in adults do not reduce all-cause, cardiovascular, or cancer mortality. Ann Int Med 158: doi: 10.7326/0003- 4819-158-2-201301150-02002

  29. Heron M (2012) Deaths: leading causes for 2008. Nat Vit Stat Reps 60:1–30

    Google Scholar 

  30. Renvert S, Ohlsson O, Pettersson T, Persson GR (2010) Periodontitis: a future risk of acute coronary syndrome? A follow-up study over 3 years. J Periodontol 81:992–1000

    Article  PubMed  Google Scholar 

  31. Belstrøm D, Damgaard C, Nielsen CH, Holmstrup P (2012) Does a causal relation between cardiovascular disease and periodontitis exist? Microbes Infect 14:411–418

    Article  PubMed  Google Scholar 

  32. CDC Periodontal Disease Surveillance workgroup, Eke PI, Dye BA, Wei L, Thornton-Evans GO, Genco J (2012) Prevalence of periodontitis in adults in the United States: 2009 and 2010. J Dent Res 91:914–920

    Article  Google Scholar 

  33. Anonymous (2011) Centers for disease control and prevention http://www.cdc.gov/diabetes/pubs/factsheet11.htm (accessed 3 Feb 2013)

  34. Regidor E, Franch J, Seguí M, Serrano R, Rodríguez-Artalejo F, Artola S (2012) Traditional risk factors alone could not explain the excess mortality in patients with diabetes: a national cohort study of older Spanish adults. Diabetes Care 35:2503–2509

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

We are grateful to the participants, counties, and municipalities. We also appreciate the interest of the older individuals who decided to participate. We thank the data manager of the Swedish National Study on Aging and Care project, Ms. Pia Gunnarsson, Blekinge Technical Institute, Sweden; RDH Christel Lindahl, University of Kristianstad, Sweden; and Ms. Johanna Renvert, University of Kristianstad, Sweden, for data control. In addition, we also thank Research Associate Professor Rigmor Persson (REP), Department of Oral Medicine at the University of Washington, for her analysis of the panoramic radiographs. The Ministry of Health and Social Affairs, Sweden, the participating county councils, municipalities, and university departments supported the Swedish National Study on Aging and Care (SNAC). In addition, the School of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden, and the University of Kristianstad, Sweden supported this part of the study.

Conflict of interest

None of the authors have a conflict of interest. All authors strictly met the authorship requirements listed by the International Committee of Medical Journal Editors (ICMJE) guidelines.

Author information

Authors and Affiliations

  1. Oral Health Sciences, University of Kristianstad, Kristianstad, 29188, Sweden

    Stefan Renvert & Rutger G. Persson

  2. School of Health Sciences, Blekinge Institute of Technology, Karlskrona, Sweden

    Stefan Renvert & Johan Berglund

  3. School of Dental Science, Trinity College, Dublin, Ireland

    Stefan Renvert & Rutger G. Persson

  4. Periodontology, Public Dental Health Services, Kristianstad, Sweden

    Viveca Wallin-Bengtsson

  5. Department of Oral Medicine, University of Washington, Seattle, WA, USA

    Rutger G. Persson

  6. Department of Periodontics, University of Washington, Seattle, WA, USA

    Rutger G. Persson

Authors
  1. Stefan Renvert
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  2. Viveca Wallin-Bengtsson
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  3. Johan Berglund
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  4. Rutger G. Persson
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Corresponding author

Correspondence to Rutger G. Persson.

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Renvert, S., Wallin-Bengtsson, V., Berglund, J. et al. Periodontitis in older Swedish individuals fails to predict mortality. Clin Oral Invest 19, 193–200 (2015). https://doi.org/10.1007/s00784-014-1214-5

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  • DOI: https://doi.org/10.1007/s00784-014-1214-5

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