{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:02:48Z","timestamp":1787018568127,"version":"build-2736575974"},"reference-count":32,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T00:00:00Z","timestamp":1662595200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["19K19309"],"award-info":[{"award-number":["19K19309"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["22K17285"],"award-info":[{"award-number":["22K17285"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Dent Res"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>Many studies suggest associations between oral health and cardiovascular diseases, but there is a lack of causal evidence. Exploiting exogenous variation in tooth loss in US adults due to differential childhood exposure to fluoridated water, this study investigated the causal effect of tooth loss on cardiovascular diseases. A total of 722,519 participants in the Behavioral Risk Factor Surveillance System (BRFSS) waves 2006, 2008, or 2010 (birth years 1940\u20131978) were included in the analytical sample. To identify the effect of tooth loss on having a history of coronary heart disease (CHD) or stroke, instrumental variable analysis exploited childhood exposure to drinking water fluoride as an instrument. The weighted prevalence of CHD and stroke histories was 5.1% and 2.1%, respectively. First-stage regression indicated that childhood exposure to drinking water fluoride was a strong instrument for the number of lost teeth in adulthood (coefficient \u22120.61; 95% confidence interval [CI] \u22120.80, \u22120.41; F\u2009=\u200937.47). The probability of CHD was significantly higher by 1.04\u2009percentage points (95% CI 0.57, 1.50) per lost tooth. The effect of tooth loss on stroke was significant only for people aged \u226560 y (coefficient 0.93\u2009percentage points; 95% CI 0.14, 1.71). These findings are supportive of a causal effect of tooth loss on cardiovascular diseases among US adults, particularly in older age.<\/jats:p>","DOI":"10.1177\/00220345221120164","type":"journal-article","created":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T01:36:06Z","timestamp":1662687366000},"page":"37-44","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":34,"title":["Causal Effect of Tooth Loss on Cardiovascular Diseases"],"prefix":"10.1177","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6114-5604","authenticated-orcid":false,"given":"Y.","family":"Matsuyama","sequence":"first","affiliation":[{"name":"Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"J\u00fcrges","sequence":"additional","affiliation":[{"name":"Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Listl","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry\u2013Quality and Safety of Oral Healthcare, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,9,8]]},"reference":[{"key":"bibr1-00220345221120164","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2017.02.020"},{"key":"bibr2-00220345221120164","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2020.09.029"},{"key":"bibr3-00220345221120164","doi-asserted-by":"publisher","DOI":"10.1177\/0022034520908533"},{"key":"bibr4-00220345221120164","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.621626"},{"key":"bibr5-00220345221120164","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwaa089"},{"key":"bibr6-00220345221120164","doi-asserted-by":"publisher","DOI":"10.1177\/154405910808700112"},{"key":"bibr7-00220345221120164","unstructured":"Centers for Disease Control and Prevention. 2010. 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