Prospective association of periodontal disease with cardiovascular and all-cause mortality: NHANES III follow-up study

Abstract Background It has been suggested that periodontal disease (PD) was associated with an increased risk for cardiovascular diseases (CVD), although evidence is inconclusive. Purpose We first sought to prospectively evaluate the relationship of PD to CVD and all-cause mortality using a national representative sample in the United States. Methods The study population consisted of 10,849 participants who were 30 years or older and received a periodontal examination from NHANES III mortality follow-up sample (1988–2006). CVD and all-cause deaths were ascertained from the National Death Index records. The causes of death were defined using the International Classification of Disease coding (ICD-10). The severity of PD was categorized as non-PD, modest and severe PD based on clinical attachment loss and pocket depth. Results Of the study sample, 3105 and 561 participants were identified as modest and severe PD cases, respectively. After up to 18 years of follow-up, there were total 2894 deaths, of which 1225 were from CVD. The levels of inflammation markers (high sensitivity C-reactive protein, white cell count and fibrinogen) were significantly higher in men with severe PD compared to men without PD ( p p Conclusions There appears to be prospective associations between PD and CVD and all-cause mortality in men aged 30–64 years. Inflammation may be one possible pathway to link PD with CVD.