Dental infections in children linked to heart disease risk in adulthood

A recent study has suggested that children who develop cavities and gum disease may be more likely to develop risk factors for heart attacks and strokes decades later than those who have good oral health

The association between childhood oral infections and adulthood carotid atherosclerosis was observed in The Cardiovascular Risk in Young Finns Study, an ongoing prospective cohort.

Researchers carried out dental examinations on 755 children in 1980, when they were eight years old on average, then followed them through 2007 to see how many of them developed risk factors for heart attacks and strokes like high blood pressure, elevated cholesterol, high blood sugar, and hardening of the arteries.

Overall, just 33 children or 4.5%, had no signs of bleeding, cavities, fillings, or pockets around teeth that can signal gum disease.

Almost 6% of the children had one of these four signs of oral infections, while 17% had two signs, 38% had three signs, and 34% had all four signs.

Children who had even one sign of oral infection were 87% more likely to develop what’s known as subclinical atherosclerosis: structural changes and thickening in the artery walls that isn’t yet serious enough to cause complications.

Children with all four signs of poor oral health were 95% more likely to develop this type of artery damage.

Oral infections are among the most common causes of inflammation-induced diseases worldwide, and periodontal disease in adults have long been linked to an increased risk of cardiovascular disease, researchers note in JAMA Network Open.

The importance of good oral hygiene

‘This emphasises how important good oral hygiene and frequent check-ups with a dentist starting early in life are for general health,’ said lead study author Pirkko Pussinen of the University of Helsinki in Finland.

‘The children with a healthy mouth had a better cardiovascular risk profile (lower blood pressure, body mass index, glucose, and cholesterol) throughout the whole follow-up period,’ Pussinen said.

Both cavities and pocketing that can signal gum disease were associated with thickening of walls of the carotid arteries, blood vessels in the neck that carry blood from the heart to the brain.

This indicates the progression of atherosclerosis and an increased risk for heart attacks and strokes.

The study wasn’t a controlled experiment designed to prove whether or how cavities or other oral health problems might directly cause heart attacks or strokes.

Not everyone with subclinical atherosclerosis or other risk factors will go on to have a heart attack or stroke.

‘The number of signs associated significantly with the cumulative exposure to the cardiovascular risk factors in adulthood, but especially in childhood,’ says Professor Markus Juonala from the University of Turku.

Both caries and periodontal diseases in childhood were significantly associated with carotid artery intima-media thickness in adulthood.

Thickening of the carotid artery wall indicates the progression of atherosclerosis and an increased risk for myocardial or cerebral infarction.

The researchers emphasise, in conclusion: ‘Oral infections were an independent risk factor for subclinical atherosclerosis; and their association with cardiovascular risk factors persevered through the entire follow-up.

‘Prevention and treatment of oral infections is important already in childhood.’

For more information on the study see: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2731677