{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T01:05:41Z","timestamp":1793235941221,"version":"4.5.0"},"reference-count":15,"publisher":"BMJ","issue":"6879","license":[{"start":{"date-parts":[[1993,3,13]],"date-time":"1993-03-13T00:00:00Z","timestamp":731980800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"published-print":{"date-parts":[[1993,3,13]]},"abstract":"<jats:p>OBJECTIVE--To investigate a reported association between dental disease and risk of coronary heart disease. SETTING--National sample of American adults who participated in a health examination survey in the early 1970s. DESIGN--Prospective cohort study in which participants underwent a standard dental examination at baseline and were followed up to 1987. Proportional hazards analysis was used to estimate relative risks adjusted for several covariates. MAIN OUTCOME MEASURES--Incidence of mortality or admission to hospital because of coronary heart disease; total mortality. RESULTS--Among all 9760 subjects included in the analysis those with periodontitis had a 25% increased risk of coronary heart disease relative to those with minimal periodontal disease. Poor oral hygiene, determined by the extent of dental debris and calculus, was also associated with an increased incidence of coronary heart disease. In men younger than 50 years at baseline periodontal disease was a stronger risk factor for coronary heart disease; men with periodontitis had a relative risk of 1.72. Both periodontal disease and poor oral hygiene showed stronger associations with total mortality than with coronary heart disease. CONCLUSION--Dental disease is associated with an increased risk of coronary heart disease, particularly in young men. Whether this is a causal association is unclear. Dental health may be a more general indicator of personal hygiene and possibly health care practices.<\/jats:p>","DOI":"10.1136\/bmj.306.6879.688","type":"journal-article","created":{"date-parts":[[2009,3,30]],"date-time":"2009-03-30T08:16:37Z","timestamp":1238400997000},"page":"688-691","source":"Crossref","is-referenced-by-count":731,"title":["Dental disease and risk of coronary heart disease and mortality."],"prefix":"10.1136","volume":"306","author":[{"given":"F","family":"DeStefano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R F","family":"Anda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H S","family":"Kahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D F","family":"Williamson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C M","family":"Russell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1993,3,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1136\/bmj.298.6676.779","article-title":"Association between dental health and acute myocardial infarction","volume":"298","author":"Mattila, K.J.; Bieminen, M.S.; Valtonen, W.; Rasi, R.P.; Kesaniemi, Y.A.; Syrajala, S.L.","year":"1989","unstructured":"Mattila KJ, Bieminen MS, Valtonen W, Rasi RP, Kesaniemi YA, Syrajala SL, et al. 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Decayed","year":"1981","unstructured":"National Center for Health Statistics. Decayed, missing, and filled teeth among persons 1-74 years: United States. Data from the National Health Survey. Hyattsville, Maryland: National Center for Health Statistics, 1981. (DHHS publication No (PHS)81-1673. Vital and health statistics; series 11; No 223.)"},{"key":"ref_4","article-title":"Oral health of United States adults, the national survey of oral health in US employed adults and seniors: 1985-86","author":"National Institute of Dental Research","year":"1987","unstructured":"National Institute of Dental Research. Oral health of United States adults, the national survey of oral health in US employed adults and seniors: 1985-86. Bethesda, Maryland: National Institute of Dental Research, 1987. (DHHS publication No (NIH)87-2868.)"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1136\/bmj.298.6687.1579-c","article-title":"Dental health and acute myocardial infarction","volume":"298","author":"Gilmour, H.; Day, E.; Northridge, D.","year":"1989","unstructured":"Gilmour H, Day E, Northridge D. Dental health and acute myocardial infarction. BMJ 1989;298:1579-80.","journal-title":"BMJ"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1136\/bmj.298.6687.1580","article-title":"Dental health and acute myocardial infarction","volume":"298","author":"Mattila, K.J.","year":"1989","unstructured":"Mattila KJ. Dental health and acute myocardial infarction. BMJ 1989;298: 1580.","journal-title":"BMJ"},{"key":"ref_7","first-page":"719","article-title":"Survival analysis with covariates-Cox models","volume-title":"statistical software manual","author":"Hopkins, A.","year":"1988","unstructured":"Hopkins A. Survival analysis with covariates-Cox models. In: Dixon WJ, ed. BMDP statistical software manual. Los Angeles: University of California Press, 1988:719-44."},{"key":"ref_8","first-page":"74","article-title":"Profiles of periodontal conditions in adults measured by CPITN","volume":"41","author":"Miyazaki, H.; Pilot, T.; Leclercq, M.-H.; Barmes, D.E.","year":"1991","unstructured":"Miyazaki H, Pilot T, Leclercq M-H, Barmes DE. Profiles of periodontal conditions in adults measured by CPITN. Int DentJ 1991;41:74-80.","journal-title":"Int DentJ"},{"key":"ref_9","first-page":"27","article-title":"Risk factors for coronary heart disease mortality among persons with diabetes","volume":"3","author":"DeStefano, F.; Ford, E.S.; Newman, J.; Stevenson, J.M.; Wetterhall, S.F.; Anda, R.F.","year":"1993","unstructured":"DeStefano F, Ford ES, Newman J, Stevenson JM, Wetterhall SF, Anda RF, et al. Risk factors for coronary heart disease mortality among persons with diabetes. 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Circulation 1987;75(suppl V):65-73.","journal-title":"Circulation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1001\/archinte.1991.00400060105018","article-title":"Dietary lipid predictors of coronary heart disease in men","volume":"151","author":"Posner, B.M.; Cobb, J.L.; Belanger, A.J.; Cupples, L.A.; D'Agostino, R.B.; J, III, Stokes","year":"1991","unstructured":"Posner BM, Cobb JL, Belanger AJ, Cupples LA, D'Agostino RB, Stokes J III. Dietary lipid predictors of coronary heart disease in men. Arch Intern Med 1991;151: 1181-7.","journal-title":"Arch Intern Med"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1001\/jama.1992.03490010070032","article-title":"Association of prior infection with Chlamydia pneumoniae and angiographically demonstrated coronary artery disease","volume":"268","author":"Thom, D.H.; Grayston, J.T.; Siscovick, D.S.; Wang, S.; Weiss, N.S.; Daling, JR","year":"1992","unstructured":"Thom DH, Grayston JT, Siscovick DS, Wang S, Weiss NS, Daling JR. Association of prior infection with Chlamydia pneumoniae and angiographically demonstrated coronary artery disease. 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