ABSTRACT
BACKGROUND
Atherosclerotic cardiovascular disease and tooth infection are common in primary care,
and both significantly reduce quality of life. Our study aimed to examine signs of
vascular inflammation associated with loss of tooth vitality before and after a single
tooth extraction.
METHODS
An observational cohort study was performed with adults who had a non-vital tooth
and an indicated desire for tooth extraction. Concentrations of total cholesterol
(TC), HDL-cholesterol (HDL-C), high sensitivity C-reactive protein (hs-CRP), myeloperoxidase
(MPO), and troponin T were measured in venous blood serum or plasma at baseline and
6-weeks after tooth extraction.
RESULTS
Circulating hs-CRP levels were > 3 mg/dL in 15 participants (68.2%) and MPO levels
were > 350 pmol/L in 9 (40.9%) of 22 participants at baseline. After tooth extraction
(n=18), MPO levels decreased significantly compared to baseline (p <0.00006) and hs-CRP
levels moved directionally downward. The response rate for MPO was 88.9% (CI: 65.1%
to 98.6%) from visit 1 to visit 2. Those with high MPO levels at baseline demonstrated
larger reductions in MPO levels by visit 2 than those with lower baseline MPO levels
(r=.81; P < 0.0001). Thirteen individuals (72.2%) achieved MPO levels < 350 pmol/L and
11 (61.1%) achieved hs-CRP levels < 3 mg/dL at visit 2. TC, HDL-C, and troponin T
levels did not significantly change from visit 1 to visit 2.
CONCLUSION
A link between dental infection and circulating levels of inflammation was observed
suggesting that oral infection could be a risk factor for atherosclerotic cardiovascular
disease.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- Inflammation and atherosclerosis: the end of a controversy.Circulation. 2017; 136: 1875-1877https://doi.org/10.1161/CIRCULATIONAHA.117.030484
- Role of myeloperoxidase in inflammation and atherosclerosis (Review).Biomed Rep. 2022; 16: 53https://doi.org/10.3892/br.2022.1536
- Myeloperoxidase - A bridge linking inflammation and oxidative stress with cardiovascular disease.Clin Chim Acta. 2019; 493: 36-51https://doi.org/10.1016/j.cca.2019.02.022
- Prevalence, impact, and predictive value of detecting subclinical coronary and carotid atherosclerosis in asymptomatic adults: the BioImage study.J Am Coll Cardiol. 2015; 65: 1065-1074https://doi.org/10.1016/j.jacc.2015.01.017
- Risk of myocardial infarction and stroke after acute infection or vaccination.N Engl J Med. 2004; 351: 2611-2618https://doi.org/10.1056/NEJMoa041747
- Oral infections and cardiovascular disease.Trends Endocrinol Metab. 2015; 26: 315-321https://doi.org/10.1016/j.tem.2015.03.001
- History of periodontitis diagnosis and edentulism as predictors of cardiovascular disease, stroke, and mortality in postmenopausal women.J Am Heart Assoc. 2017; 6https://doi.org/10.1161/JAHA.116.004518
- Bacterial signatures in thrombus aspirates of patients with myocardial infarction.Circulation. 2013; 127 (e1211-1216): 1219-1228https://doi.org/10.1161/CIRCULATIONAHA.112.001254
Endodontics Diagnosis. American Association of Endodontists. https://www.aae.org/specialty/wp-content/uploads/sites/2/2017/07/endodonticdiagnosisfall2013.pdf. Accessed 1 November, 2022.
- The international caries classification and management system (ICCMS) an example of a caries management athway.BMC Oral Health. 2015; 15 (S9)https://doi.org/10.1186/1472-6831-15-S1-S9
- A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification.J Periodontol. 2018; 89: S1-S8https://doi.org/10.1002/JPER.18-0157
- Utility of salivary biomarkers for demonstrating acute myocardial infarction.J Dent Res. 2014; 93: 72S-79Shttps://doi.org/10.1177/0022034514537522
- Myeloperoxidase serum levels predict risk in patients with acute coronary syndromes.Circulation. 2003; 108: 1440-1445https://doi.org/10.1161/01.CIR.0000090690.67322.51
- Myeloperoxidase: a new biomarker of inflammation in ischemic heart disease and acute coronary syndromes.Mediators Inflamm. 2008; 2008135625https://doi.org/10.1155/2008/135625
- Definitions and epidemiology of endodontic infections.Curr Oral Health Rep. 2017; 4: 278-285https://doi.org/10.1007/s40496-017-0161-z
- Diverse and novel oral bacterial species in blood following dental procedures.J Clin Microbiol. 2008; 46: 2129-2132https://doi.org/10.1128/JCM.02004-07
- Intravenous amoxicillin/clavulanate for the prevention of bacteraemia following dental procedures: a randomized clinical trial.J Antimicrob Chemother. 2016; 71: 2022-2030https://doi.org/10.1093/jac/dkw081
- The effect of treated apical periodontitis before heart valve surgery on C-reactive protein levels.Oral Dis. 2021; 27: 632-638https://doi.org/10.1111/odi.13554
Article info
Publication history
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
