Dental Health, Cardiovascular Disease Risk, and Systemic Inflammation in Children

Objective: A growing body of epidemiologic evidence links oral health, periodontal disease, and cardiovascular health, though few studies have reported on relationships, if any, in children. While underlying pathophysiologic mechanisms in adults are unclear, several studies have suggested a chronic, sub-acute inflammatory state, also implicated in the pathogenesis and etiology of cardiovascular disease. The objective of this study was investigate the link between dental health practices, cardiovascular disease risk factors, and systemic inflammation in children. Patients and Methods: 128 children <19 years of age from 5 different counties in West Virginia were recruited to participate in a comprehensive, community-based health screening that included anthropometric assessments, collection of blood specimen, and completion of a questionnaire about oral health and dental habits. Results: Participants ranged in age from 3.0-18.7, and 51.6% were girls. In univariate analysis, characteristics of preventive dental care and overall dental health were statistically related to and several traditional cardiovascular disease (waist circumference, LDL, fasting glucose, systolic blood pressure percentile) and multiple markers of systemic inflammation (TNF-á, tPAI-1, sVCAM-1, sICAM-1). In logistic and OLS regression analysis, after controlling for traditional measures of cardiovascular disease risk, gender, and socioeconomic status, dental hygiene and overall dental health maintained statistically significant, ceteris paribus, and independent predictive effects on the presences of any cardiovascular disease risk factor and markers of systemic inflammation. Some gender specific effects were observed. Conclusions: This is the first known study to report on the relationship between dental health and hygiene and cardiovascular disease risk and systemic inflammation in children. These results highlight the importance of preventive dental care in overall, systemic health in children and are consistent with previous reports in adults. While additional studies are needed in a broader pediatric population, continued consistent findings – that dental health is a key component to overall health – attitudes and policies suggesting that dental insurance is an optional supplement to health insurance may need to be re-evaluated.