Decayed Teeth and Atherosclerosis : Current Evidence

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  • OJIMA Miki
    Department of Preventive Dentistry, Osaka University Graduate School of Dentistry

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  • う蝕と動脈硬化 : 最近のエビデンス
  • ウショク ト ドウミャク コウカ : サイキン ノ エビデンス

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Abstract

 Although accumulated epidemiological and biological evidence has revealed that periodontal disease is associated with atherosclerosis, the association of dental caries with the disease is not well understood. The objective of this study was to review current biological and epidemiological evidence of adult dental caries and atherosclerosis, in order to assess risk factors. The association between dental caries and atherosclerotic lesions has not been clearly demonstrated. A few epidemiological studies have shown that adults with a higher level of alcohol consumption or frequent sugar intake had more decayed teeth compared with those without such habits. Based on epidemiological findings published after 1950 as well as biological findings, a relationship between active smoking and adult dental caries is thought to exist. In addition, metabolic syndrome is an accumulation of conditions that also increase the risk of atherosclerosis, such as obesity, hypertension, dyslipidemia, and hyperglycemia, and a study of middle-aged Japanese men reported that the number of decayed teeth was significantly correlated with increased odds of metabolic syndrome after adjustments for health behaviors as potential confounders. That relationship was observed even in men without periodontal pocket formation and those without missing teeth, while it was also revealed that the presence of decayed teeth was significantly correlated with each of those atherosclerotic risk factors. Although the underlying mechanisms of the relationship of decayed teeth with atherosclerosis remain unclear, recent reports have noted the involvement of Streptococcus mutans, a cariogenic dental pathogen, in the pathogenesis of atherosclerosis. The high prevalence of metabolic syndrome is a global public health problem, and 50% of men and 20% of women in Japan have that or pre-metabolic syndrome. Oral health professionals are encouraged to provide education through health services regarding the adverse effects of decayed teeth, as well as the importance of dental caries treatment for the prevention and control of metabolic syndrome and atherosclerosis. Nevertheless, because of insufficient evidence, further research is needed to investigate whether dental caries is a true risk factor for atherosclerosis, including molecular biological experiments and longitudinal epidemiological studies.

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