Physicians' Academy for Cardiovascular Education

Poor oral hygiene correlates with maximal cIMT and atherosclerotic plaque

Literature - Yu H et al., J Dent Res. 2014 - J Dent Res. 2014 Jun 16


Association of Carotid Intima-media Thickness and Atherosclerotic Plaque with Periodontal Status

Yu H, Qi LT, Liu LS, Wang XY, Zhang Y, Huo Y.
J Dent Res. 2014 Jun 16. [Epub ahead of print]


Chronic inflammatory reaction occurs throughout atherogenesis, and both epidemiological and microbiological studies have shown a possible association between clinical/subclinical atherosclerosis and chronic periodontitis [1-4]. Mechanisms linking the two diseases remain to be determined.
Hyperglycaemic individuals are at higher risk of both atherosclerosis and chronic periodontitis, which further suggests a link between the two conditions [5,6].
In China, chronic periodontitis is a public oral health problem. This study aimed to investigate the association between subclinical atherosclerosis and periodontal status in China. 434 men and 413 women were included in this study. 245 of 847 participants were regarded as having atherosclerosis plaque (maximal carotid intima media thickness (cIMT) >1.2 mm).

Main results

  • Over the whole sample, cIMT was significantly correlated with mean plaque index (PLI), in a multiple linear regression model adjusting for multiple traditional risk factors (nonstandardised β: 0.068 (95%CI: 0.033-0.103, P<0.001). Euglycaemic participants showed a similar correlation.
  • In hyperglycaemic patients, a correlation was found between mean attachment loss (AL) and cIMT, such that each 1-mm increment in mean AL corresponded to a 0.018-mm increase in maximal cIMT after adjustment (95%CI: 0.005-0.031, P=0.006).
  • In multiple logistic regression, the whole sample showed a greater risk of atherosclerotic plaque with increased mean PLI (adj OR: 2.051, 95%CI: 1.410-2.982) after adjusting for traditional risk factors. A similar OR was seen in euglycaemic participants.
  • In hyperglycaemic participants, the prevalence of atherosclerotic plaque was significantly correlated with mean AL (adj OR: 1.183, 95%CI: 1.021-1.371, P=0.025), and AL 3% (meaning sites with AL >3mm), AL 4% and AL 5% were also all mildly but significantly correlated with increased risk of atherosclerotic plaque.


This study shows that mean PLI, an important indicator of oral hygiene, was correlated with cIMT and atherosclerotic plaque in the total study sample, and in euglycaemic participants. Clinical AL, which reflects the extent of periodontal tissue destruction, was associated with maximal cIMT in a dose-dependent manner and atherosclerotic plaque in hyperglycaemic participants.
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