Five Continents, One Result
These findings come from a comprehensive review of data from the STABILITY trial. It’s a huge trial for a drug intended to treat arterial plaque. The trial includes 15,456 patients from 39 countries on five continents. Initially, data on tooth loss was collected to help eliminate confounders that could obscure the data. Other types of confounder data that was collected included smoking, physical activity, and psychological factors.
For analysis, researchers broke patients down into five categories of tooth loss:
- 26-32 teeth (considered all teeth)
- 20-25 teeth
- 15-19 teeth
- 1-14 teeth
- No teeth
From the very beginning, the trial population was seen to have poor oral health. About 16% of patients had lost all their teeth, and about 45% had lost half their teeth. For comparison, about 4.9% of the US population has lost all their teeth.
These patients were followed for an average of 3.7 years, and over that time they were monitored for major cardiovascular events such as heart attack, stroke, and cardiovascular death, abbreviated MACE.
Over the observation period, they found that every increase in tooth loss category (e.g. from 26-32 teeth to 20-25 teeth) was associated with a 6% increase in MACE risk. This included a 7% increase in stroke risk, and a whopping 17% increase in the risk of cardiovascular death! In addition, the risk of all-cause death increased by 16% for every category of tooth loss.
The group with no teeth had an 85% higher risk of cardiovascular death and an 81% higher risk of all-cause death than the group with all teeth. They also had a 27% higher risk of MACE, and a 67% increase in stroke risk.
Gum Disease Is the Likely Link
This study was not designed to look at the link between tooth loss, gum disease, and cardiovascular death. This is just something that became glaringly obvious from the data that came out of their study. But it means that the results don’t actually establish a causal link.
However, we know that gum disease contributes to heart risk. We know that oral bacteria are commonly found in arterial plaque. We even know that treating gum disease can improve heart health. Because gum disease is the most common cause of tooth loss, these results may not give us a smoking gun, but they show gunshot residue all over the scene.