# Association between subclinical coronary artery atherosclerosis and oral health—a study on a Swedish population

## TL;DR

This study finds a link between poor oral health and early signs of heart disease in a Swedish population, suggesting oral health data could help predict heart risks, especially in women.

## Contribution

The study demonstrates that oral health indicators improve the prediction of subclinical coronary artery atherosclerosis, particularly in women.

## Key findings

- Individuals with subclinical coronary artery atherosclerosis had more missing teeth and worse oral health indicators.
- Missing teeth was an independent risk indicator for subclinical coronary artery atherosclerosis.
- Adding oral health data improved model performance for predicting heart disease risk, especially in women.

## Abstract

Oral health has been linked to cardiovascular disease (CVD), but its relationship to subclinical coronary artery atherosclerosis (SCAA) remains unclear. Using coronary computed tomography angiography (CCTA), we explored this association in an asymptomatic population.

A total of 410 non-smokers (193 women, mean age: 64.6 years), comprising 204 individuals with SCAA and 206 without (non-SCAA), were assessed through clinical and radiographic oral evaluations. Self-reported oral symptoms were scored by questionnaire. We used sex-stratified regression analysis and compared model performance with and without the addition of data on oral health through area under the curve (AUC). The reference model included age and history of smoking.

Individuals with SCAA had more missing teeth, higher Decayed and Filled Teeth scores and greater prevalence of peri-apical lesions and marginal bone loss >33%. Missing teeth was an independent risk indicator for SCAA (OR 1.15 95%CI 1.04–1.27). Model performance improved with the addition of oral status and self-reported oral symptoms, most prominently in women (AUC 0.67 vs. 0.78, p = 0.010). Decision curve analyses confirmed a consistent net benefit when data on oral health were considered.

The findings suggest that subclinical coronary artery atherosclerosis is associated with oral health. Oral health-related data may improve screening for risk of coronary events, especially in women.