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Losing a substantial number of teeth was independently associated with cardiovascular events in people with stable coronary heart disease, a large international cohort study showed.

Compared with having lost no more than six teeth, people who lost all their original teeth had a 27% elevated adjusted risk of cardiovascular death, nonfatal myocardial infarction (MI), or nonfatal stroke (HR 1.27, 95% CI 1.08-1.49), , MD, of Sweden's Uppsala University, and colleagues found.

The same comparison was significant also for cardiovascular death (HR 1.85, 95% CI 1.45-2.37), all-cause death (HR 1.81, 95% CI 1.50-2.20), and stroke (HR 1.67, 95% CI 1.15-2.39).

Each intermediate level of self-reported tooth loss was also associated with progressively higher risks after adjustment for cardiovascular risk factors and socioeconomic status, the researchers .

But no associations were seen with nonfatal or fatal MI among the 15,456 patients in 39 countries in the STABILITY trial substudy. About 16% of patients in the study had no teeth and roughly 40% were missing half of their teeth.

"This finding indicates that mechanisms leading to tooth loss, most importantly periodontal disease, may contribute to a worse prognosis in coronary heart disease, although causality cannot be established from our results," the researchers cautioned.

"But tooth loss could be an easy and inexpensive way to identify patients at higher risk who need more intense prevention efforts," Vedin said in a press release. "While we can't yet advise patients to look after their teeth to lower their cardiovascular risk, the positive effects of brushing and flossing are well established. The potential for additional positive effects on cardiovascular health would be a bonus."

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