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Finnish study links childhood oral infections and adult carotid atherosclerosis

By Dental Tribune International
June 26, 2019

HELSINKI, Finland: Studies that link oral infections with systemic diseases and conditions have been going on for a long time. A recent Finnish study, after a 27-year follow-up, has revealed that childhood oral infections, such as caries and periodontal diseases, are associated with a greater risk of atherosclerosis in adulthood. This is a significant finding, which emphasises the need for a quality oral care during childhood.

Periodontal diseases and dental caries, both of which initiate early in life, are known to be the most common chronic infection induced inflammatory diseases worldwide. It‘s critical to diagnose and treat them in their early stages, because if early signs go undetected, the untreated diseases may lead to more severe infections, which may result in tooth loss. The role of childhood oral infections in cardiovascular risk has been poorly understood, and it needed a long term study to answer the complex question of causality.

This study was initiated in 1980, through a collaboration between the Department of Oral and Maxillofacial Diseases, University of Helsinki and the research group participating in the national Cardiovascular Risk in Young Finns Study. First, 755 children aged 6, 9 and 12 years underwent clinical oral examinations at the start of the study, and at regular intervals later, their cardiovascular risk factors were measured. The follow-up took place 27 years later in 2007, when the same participants aged 33, 36 and 39 years, underwent an ultrasound examination for the measurement of carotid artery intima-media thickness.

The study included four signs of oral infection: caries, fillings, bleeding on probing, and pockets. At the baseline, 68 per cent children had bleeding on probing, 87 per cent showed caries and 82 per cent had received restorations. No difference was observed between boys and girls in these three parameters. However, slight periodontal pockets observed in 54 per cent of the children showed higher frequency in boys than in girls. The study also showed that 61 per cent of the children had one to three signs of oral infection, whereas 34 per cent had all four signs of oral infection. Only 5 per cent of them were totally healthy.

The researchers, at different intervals of time, measured the thickening of the carotid artery wall, which indicates the progression of atherosclerosis and an increased risk for myocardial or cerebral infarction. They found a significant association between both childhood caries and periodontal diseases with carotid artery intima-media thickness in adulthood.

Prof. Markus Juonala from the University of Turku, Finland, who was a co-author in this study, stated “The number of signs is associated significantly with the cumulative exposure to the cardiovascular risk factors in adulthood, but especially in childhood,” The study concluded that the childhood oral infections are associated with the subclinical carotid atherosclerosis in adulthood. Hence, the message on the importance of maintaining good oral health right from childhood needs to reach maximum people globally.

The study, titled “Association of childhood oral infections with cardiovascular risk factors and subclinical atherosclerosis in adulthood”, was published online in JAMA Network Open on 26 April 2019.

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