Chronic dental diseases and systemic health : cardiovascular diseases and cancer

Eunice Virtanen

Forskningsoutput: AvhandlingDoktorsavhandlingSamling av artiklar


Chronic dental diseases are highly prevalent worldwide. The possible associations between oral diseases and general health have been studied and periodontitis has been associated with cardiovascular diseases, diabetes, pre-term and low-birth weight infants, Alzheimer’s disease, and also with cancer. Apical periodontitis associates with cardiovascular diseases and diabetes. Nevertheless, causality has been difficult to address due to common background variables. Cardiovascular diseases are the number one killer in the world and cancer is the second leading cause of death worldwide. To better understand the possible associations between general health and oral conditions we set out to study a Swedish population cohort that was originally examined in 1985 (n=1676). The hypothesis was that there is a link between periodontitis, apical periodontitis, systemic diseases and cancer. In 2003 (n=120) and 2009 (n=90) follow-up examinations were conducted and national cumulated cancer data and hospital registers were respectively used to analyze the eventual associations with oral health parameters. In 2003 full-mouth x-rays were also taken and in 2009 saliva and serum samples collected. Appropriate statistical methods were used to analyze the results, including analyses of variance and covariance, chi-square, Fisher’s exact t-test, Mann-Whitney U test, Bonferroni corrections and multiple regression analyses. The main results were that the incidence of cancer associated with missing teeth and age in the study population. In 2009, the prevalence of cancer in periodontally healthy patients associated with missing d47 and age with odds ratio (OR) 2.62 (95% CI 1.18-5.78) and 1.91 (1.06-3.43), respectively. Furthermore, apical periodontitis associated with higher risk of having cardiovascular disease with an OR 3.90 (1.20-12.65), when controlled for periodontitis and other co-factors. Apical periodontitis was common among the subjects (41%) and the quality of root treatments was mainly poor. No significant differences were found in serum and saliva concentrations of the biomarkers MMP-8, MMP-9 and TIMP-1; but higher MMP-13 saliva concentration associated with female gender and clinical attachment loss with OR 3.08 (1.17-8.11) and 3.57 (1.18-11.82), respectively. To conclude, oral infections were prevalent in this study population and statistical links were found between them and cardiovascular diseases and cancer. Age is an important factor for several systemic diseases and also for the oral diseases. Finally, several common factors may influence the balance between health and disease, such as the genome, the environment and the behavior. These factors relate both to oral and systemic diseases, making it difficult to prove any causality between these diseases.
  • Meurman, Jukka, Handledare
  • Soder, Birgitta, Handledare, Extern person
Tilldelningsdatum28 sep 2018
Tryckta ISBN978-951-51-4495-9
Elektroniska ISBN978-951-51-4496-6
StatusPublicerad - 2018
MoE-publikationstypG5 Doktorsavhandling (artikel)

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  • 313 Odontologi
  • 3121 Inre medicin
  • 3122 Cancersjukdomar

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