Gum disease, tooth loss may increase postmenopausal women's risk of death

Gum disease and tooth loss may be associated with a higher risk of death in postmenopausal women but not increased cardiovascular disease risk, according to new research in Journal of the American Heart Association, the open access journal of the American Heart Association/American Stroke Association.

Loss of all natural teeth also was linked with an increased risk of death in postmenopausal women, according to the study led by UB researchers.

Periodontal disease, a chronic inflammatory disease of the gum and connective tissue surrounding the teeth, affects nearly two-thirds of U.S. adults 60 and older. The loss of all one’s teeth, called edentulism, impacts about one-third of U.S. adults 60 and older and often results from periodontal disease.

“Beside their negative impact on oral function and dietary habits, these conditions are also thought to be related to chronic diseases of aging,” said Michael J. LaMonte, PhD, study author and research associate professor of epidemiology and environmental health in UB’s School of Public Health and Health Professions.

Researchers analyzed the health information from the Women’s Health Initiative program — a study of 57,001 women, 55 years and older.

“Previous studies included smaller sample sizes or had limited numbers of cardiovascular disease events for analysis. Ours is among the largest and focuses exclusively on postmenopausal women in whom periodontitis, total tooth loss and cardiovascular disease is high nationally,” LaMonte said.

In 6.7-year follow up of postmenopausal women studied, they found:

• There were 3,589 cardiovascular disease events and 3,816 deaths.
• History of periodontal disease was associated with a 12 percent higher risk of death from any cause.
• Loss of all natural teeth was associated with a 17 percent higher risk of death from any cause. The risk of death associated with periodontal disease was comparable regardless of how often women saw their dentists.
• Women who had lost their teeth were older, had more CVD risk factors, less education and visited the dentist less frequently compared to women with their teeth.

“Our findings suggest that older women may be at higher risk for death because of their periodontal condition and may benefit from more intensive oral screening measures,” LaMonte said.

“However, studies of interventions aimed at improving periodontal health are needed to determine whether risk of death is lowered among those receiving the intervention compared to those who do not. Our study was not able to establish a direct cause and effect.”

LaMonte’s UB co-authors are Robert J. Genco, SUNY Distinguished Professor in the Department of Oral Biology, School of Dental Medicine, and, from the School of Public Health and Health Professions: Kathleen M. Hovey, data manager/statistician; Jo L. Freudenheim, UB Distinguished Professor, professor and chair of epidemiology and environmental health; Xiaodan Mai, Department of Epidemiology and Environmental Health; and Jean Wactawski-Wende, dean, SUNY Distinguished Professor and professor of epidemiology and environmental health.

Additional co-authors are from the University of Iowa; Tufts University; Fred Hutchinson Cancer Research Center; Albert Einstein College of Medicine; University of Michigan; University of Massachusetts; Brown University; and George Washington University.

The National Heart, Lung, and Blood Institute supported the study.