Strong Heart, Strong Smile: Tooth Loss and Incidence of CVD in American Indian Populations.

IF 2.1 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology Pub Date : 2025-08-31 DOI:10.1111/cdoe.70020

Lindsey Montileaux Mabbutt, Paul Jensen, Amanda Fretts, Lyle Best, Joana Cunha-Cruz

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引用次数: 0

Abstract

Objectives: Tooth loss and cardiovascular disease (CVD) share risk factors and complex pathways in disease progression and co-morbidities. To date, little research on the relationship between tooth loss and CVD has been conducted in American Indian populations. This study investigated the prevalence of edentulism among American Indian adults and its association with the incidence of CVD.

Methods: The ongoing longitudinal Strong Heart Study (SHS) is being conducted in rural American Indian communities in North Dakota, South Dakota and Oklahoma since 1989. This cohort study included SHS participants who had available tooth loss data during the 1997-1999 wave, which serves as the baseline for this analysis. Data analysis was performed in August 2023. Anthropometric, health and behaviour data were obtained from physical exams and interviews. Participants who reported no natural teeth were considered edentulous. CVD events were obtained from continuous mortality and morbidity surveillance through 2019. Crude and adjusted Cox proportional hazards regression models were fit to examine the association of edentulism with CVD events.

Results: Of 1982 participants, 29% (n = 584) were edentulous at baseline, and 41% (n = 822) developed CVD during up to 22 years follow-up. When adjusting for site, age, sex, education, smoking, diabetes, BMI and hypertension, the hazard ratio for developing CVD was 1.36 (95% CI: 1.15, 1.60) for the participants who were edentulous when compared to those reporting natural teeth present.

Conclusions: The findings confirm the high burden of oral diseases and CVD among this sample of American Indians and suggest a significant positive association between edentulism and incidence of CVD that was partially explained by shared risk factors. The study highlights the need for interventions that address risk factors for non-communicable diseases to improve both oral health and cardiovascular health of American Indians.

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强壮的心脏，坚强的微笑：美洲印第安人牙齿脱落和心血管疾病的发病率。

目的：牙齿脱落和心血管疾病（CVD）在疾病进展和合并症中具有共同的危险因素和复杂的途径。迄今为止，关于牙齿脱落和心血管疾病之间关系的研究很少在美洲印第安人中进行。本研究调查了美国印第安成年人的牙髓病患病率及其与心血管疾病发病率的关系。方法：自1989年以来，在北达科他州、南达科他州和俄克拉何马州的农村美国印第安人社区进行了正在进行的纵向强心脏研究（SHS）。该队列研究包括在1997-1999年期间有牙齿脱落数据的SHS参与者，作为本分析的基线。数据分析于2023年8月进行。从体格检查和访谈中获得人体测量学、健康和行为数据。报告没有天然牙齿的参与者被认为是无牙的。通过2019年的连续死亡率和发病率监测获得CVD事件。粗Cox比例风险回归模型和校正后的Cox比例风险回归模型适合于检验牙槽牙症与CVD事件的关系。结果：1982名参与者中，29% （n = 584）在基线时无牙，41% （n = 822）在长达22年的随访中发展为心血管疾病。当调整了地点、年龄、性别、教育程度、吸烟、糖尿病、BMI和高血压等因素后，无牙者与有天然牙齿者发生心血管疾病的风险比为1.36 （95% CI: 1.15, 1.60）。结论：研究结果证实了美洲印第安人口腔疾病和心血管疾病的高负担，并表明在牙齿治疗和心血管疾病发病率之间存在显著的正相关，这在一定程度上可以通过共同的危险因素来解释。该研究强调需要采取干预措施，解决非传染性疾病的风险因素，以改善美洲印第安人的口腔健康和心血管健康。

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来源期刊

Community dentistry and oral epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.40

自引率

8.70%

发文量

审稿时长

6 months

期刊介绍： The aim of Community Dentistry and Oral Epidemiology is to serve as a forum for scientifically based information in community dentistry, with the intention of continually expanding the knowledge base in the field. The scope is therefore broad, ranging from original studies in epidemiology, behavioral sciences related to dentistry, and health services research through to methodological reports in program planning, implementation and evaluation. Reports dealing with people of all age groups are welcome. The journal encourages manuscripts which present methodologically detailed scientific research findings from original data collection or analysis of existing databases. Preference is given to new findings. Confirmations of previous findings can be of value, but the journal seeks to avoid needless repetition. It also encourages thoughtful, provocative commentaries on subjects ranging from research methods to public policies. Purely descriptive reports are not encouraged, nor are behavioral science reports with only marginal application to dentistry. The journal is published bimonthly.