Background and Objectives: Coronary atherosclerosis remains a leading cause of global morbidity and mortality. Chronic systemic inflammation has emerged as a key factor in atherosclerosis development. Tooth loss—often the final consequence of periodontitis—has been proposed as a potential clinical marker of systemic inflammation and cardiovascular risk. Objective: This narrative review synthesizes the available literature on the relationship between tooth loss and coronary artery disease (CAD) severity, exploring biological mechanisms, key epidemiological findings, and clinical implications. Materials and Methods: We reviewed observational studies, meta-analyses, and clinical reports assessing whether tooth loss is predictive of CAD severity and adverse outcomes. Results: A consistent association is reported between tooth loss and increased coronary involvement. Proposed mechanisms include periodontal inflammation, dysbiosis, systemic inflammatory responses, and translocation of oral bacteria. However, confounders such as smoking, diabetes, and socioeconomic status complicate causality. Conclusions: Tooth loss may serve as a simple, non-invasive clinical indicator of systemic inflammation and CAD severity. Incorporating oral health evaluation into cardiovascular risk assessment could enhance early detection and prevention strategies. Further longitudinal and interventional studies are required to establish causality and inform clinical guidelines.

Here, we report an unusual case of a nonsmoker and hypertensive 72-year-old male who was admitted with a transient ischemic attack to the Neurology Department of Clinical County Emergency Hospital Bihor. He presented a first transient ischemic attack and paroxysmal atrial fibrilation 2 years before, when anticoagulation was started on top of his antihypertensive medication. At that time, carotid Doppler ultrasound revealed nonobstructive atherosclerosis and statin therapy was started, according to current guidelines, in order to lower the initial 70 mg/dL LDL-cholesterol level to under 55 mg/dL. Cardio-embolism was considered the mechanism of stroke at that time. Despite all the medication and the maintenance of LDL below 50 mg/dL, carotid atherosclerosis evolved to an important left internal carotid artery stenosis and transient ischemic attacks reappeared two years later. Carotid stenosis was then considered the most probable cause, although elucidating the exact mechanism was difficult. After medical treatment and subsequent endarterectomy, the patient had a good outcome. The progressive course of atheromatosis, despite maximal medication, urged us to look for further proper measures of prevention. No chronic disease was detected during the postoperative phase, except for early-stage periodontal disease, for which adequate preventive measures were applied. Considering that subclinical inflammation induced by periodontal disease can induce the progression of atherosclerosis, chronic treatment with colchicine was added, with a favorable outcome.

Background: Tooth loss reflects cumulative oral inflammation and has been associated with adverse cardiovascular outcomes. This study evaluated the relationship between the number of missing permanent teeth and the angiographic severity of coronary artery disease (CAD) in patients with acute myocardial infarction (AMI). Methods: In this prospective cross-sectional study, 200 consecutive AMI patients underwent coronary angiography and standardized dental assessment during hospitalization. Tooth loss was categorized as 1–10, 11–20, or 21–32 missing teeth. CAD severity was defined by the number of major epicardial arteries with significant stenosis. Multivariate logistic regression adjusted for age, sex, smoking status, diabetes, obesity, dyslipidemia, and hypertension. Results: Increasing tooth loss was associated with more extensive CAD. The mean number of affected vessels rose from 1.58 ± 0.79 in the 1–10 tooth-loss group to 2.06 ± 0.99 in the 21–32 group (p = 0.014). Tooth loss correlated with CAD severity (r = 0.19, p = 0.007). After adjustment, >20 missing teeth remained an independent predictor of multivessel disease (OR = 1.84; 95% CI: 1.01–3.34; p = 0.047). ROC analysis showed modest discrimination (AUC = 0.61). Conclusions: Extensive tooth loss independently correlates with greater angiographic CAD severity in AMI patients. Dental status may serve as a simple, non-invasive clinical marker of cardiovascular disease burden.

Background: Oral and cardiovascular health share inflammatory and behavioral pathways. Chronic oral inflammation leading to tooth loss may reflect systemic vascular injury. The relationship between tooth loss and cardiovascular risk among patients with myocardial infarction (MI) remains underexplored. Objective: We hypothesized that in post-MI patients, the extent of tooth loss reflects cumulative systemic inflammatory exposure and correlates with major cardiovascular risk factors and coronary artery disease severity. Methods: In this cross-sectional study, 200 consecutive MI patients (mean age 64 years, 65% male) underwent oral examination and cardiovascular risk assessment. Logistic and robust linear regression models were applied to identify independent predictors of tooth loss. Results: The median number of missing teeth was 20 (IQR 12–28). Age (OR 1.13/year, p < 0.001; β = 0.53, p < 0.001) and smoking (OR 3.28, p = 0.007; β = 3.13, p = 0.027) were significant independent predictors. Diabetes showed a borderline association (OR 2.20, p = 0.054), and a trend was observed with the number of affected coronary arteries (β = 1.05, p = 0.063). Conclusions: Tooth loss in MI patients is closely associated with age and smoking and may indicate cumulative inflammatory burden. As a simple, non-invasive marker, tooth loss could aid cardiovascular risk stratification and encourage interdisciplinary prevention integrating cardiology and dental care.

Background: Tooth loss is a cumulative oral-health outcome associated with reduced quality of life and several behavioral and systemic factors. Fewer studies have examined oral hygiene and multiple cardiovascular risk factors simultaneously in relation to the number of missing teeth within the same ambulatory clinical population. Our study examined the cross-sectional associations of oral hygiene status and major cardiovascular risk factors with the number of missing natural teeth in an ambulatory adult population. Methods: In this cross-sectional study, 1031 ambulatory adults underwent clinical assessment of missing natural teeth and oral hygiene status, categorized as good, fair, or poor. Hypertension, obesity, dyslipidemia, current smoking, and diabetes mellitus were recorded. Multivariable negative binomial regression adjusted simultaneously for oral hygiene status, age, sex, and the measured cardiovascular risk factors was the primary analysis, with multivariable linear regression used as a supportive analysis. Results: The mean number of missing teeth increased across oral hygiene categories. In the adjusted negative binomial model, fair oral hygiene (IRR 1.179, 95% CI 1.114–1.248) and poor oral hygiene (IRR 1.490, 95% CI 1.406–1.579) were associated with a higher expected number of missing teeth compared with good oral hygiene. Increasing age (IRR 1.031 per year, 95% CI 1.029–1.033), current smoking (IRR 1.147, 95% CI 1.099–1.198), and diabetes mellitus (IRR 1.118, 95% CI 1.056–1.182) were also associated with a higher expected number of missing teeth. Sex, hypertension, obesity, and dyslipidemia were not statistically significant in the fully adjusted model. Conclusions: Poorer oral hygiene, older age, current smoking, and diabetes mellitus were associated with a greater number of missing teeth after adjustment for the other measured covariates. Because current oral hygiene and cumulative tooth loss were assessed at the same visit, temporal and causal relationships cannot be established. Furthermore, multimorbidity and polypharmacy were not systematically assessed, and their potential contribution to the observed associations could not be evaluated.

Background: Oral health and cardiovascular disease share common inflammatory pathways, yet the relationship between tooth loss and post-myocardial infarction (MI) heart failure remains underexplored. Objective: To investigate the association between tooth loss and heart failure among patients with acute MI. Methods: In this cross-sectional study, 200 patients with documented MI were evaluated for tooth loss, cardiac function, and comorbidities. Heart failure was defined as an ejection fraction 20 missing teeth). Multivariate logistic regression was used to identify independent predictors of heart failure. Model performance was assessed using receiver operating characteristic (ROC) analysis. Results: The prevalence of heart failure was 38%. Mean ejection fraction declined progressively with greater tooth loss (50.1%, 44.8%, and 38.4% across the three categories; p for trend 20 missing teeth) remained independently associated with heart failure (adjusted OR 2.45; 95% CI, 1.15–5.23; p = 0.02). The final model demonstrated good discriminative ability (AUC = 0.78). Conclusions: Extensive tooth loss is strongly associated with heart failure among MI patients, suggesting a potential link between oral health deterioration and adverse cardiac remodeling. Integrating dental assessment into cardiovascular care may enhance risk stratification and promote holistic prevention strategies.