Oral health is an essential determinant of general health, particularly in elderly populations. Over the past few decades, research has increasingly shown that poor oral health—especially periodontal disease and tooth loss—can influence the development and progression of systemic diseases, notably cardiovascular disease (CVD)1-4. Edentulism, or complete tooth loss, is a severe outcome of chronic oral conditions such as periodontitis and dental caries and represents the end-stage of oral disease progression. Although complete dentures restore oral function and aesthetics, they do not reverse the systemic inflammatory burden associated with a history of periodontal disease5.

The global prevalence of edentulism is rising, particularly in populations over the age of 60. According to the Global Burden of Disease Study, oral diseases affected 3.5 billion people worldwide in 2019, with severe periodontal disease being the 11th most prevalent condition6. Edentulism, often considered a marker of socio-economic disadvantage, limited access to dental care, and neglect of oral hygiene, may also reflect a history of chronic inflammation. This inflammation, often persistent long after tooth extraction, is thought to contribute to systemic endothelial dysfunction, increased atherogenesis, and a higher risk of cardiovascular events7,8.

Cardiovascular disease remains the leading cause of mortality worldwide, accounting for over 17 million deaths annually. While traditional risk factors such as hypertension, dyslipidemia, obesity, smoking, and diabetes mellitus are well established, there is increasing interest in non-traditional risk factors such as chronic oral infections and inflammation9. The mouth acts as a portal of entry for pathogenic microorganisms into the systemic circulation, where they may incite low-grade inflammation, thereby contributing to atheroma formation and cardiovascular instability10.

Periodontal disease, a chronic inflammatory disease caused by plaque biofilm accumulation, leads to progressive destruction of the supporting structures of the teeth. Its systemic effects are mediated through pro-inflammatory cytokines such as IL-6, TNF-α, and CRP, which can have deleterious effects on vascular endothelium and lipid metabolism. Consequently, individuals who suffered from periodontitis before becoming edentulous may retain the systemic burden long after teeth are lost11.

Several studies have indicated an association between periodontal status and cardiovascular risk, but few have specifically explored this relationship in edentulous individuals who wear complete dentures. It remains unclear whether the systemic inflammatory load decreases after tooth loss or persists due to residual periodontal pathogens in alveolar bone, peri-implant regions, or oral mucosa9.

This study aims to evaluate the correlation between historical periodontal status, current cardiovascular risk profiles, and the edentulous condition in complete denture wearers. We hypothesize that a significant proportion of edentulous patients with a history of advanced periodontal disease have higher cardiovascular risk markers and that the duration of edentulism may further influence cardiovascular outcomes.

Study Design: Cross-sectional analytical study.

Sample Size: 200 complete denture wearers aged 45 years and above.

Inclusion Criteria:

• Patients with complete edentulism for ≥1 year.
• Wearing complete dentures.
• Availability of historical dental records indicating periodontal status.

Exclusion Criteria:

• Individuals with congenital edentulism.
• Recent extractions (<12 months).
• Those with autoimmune disorders or active infections.

Data Collection:

1. Historical Periodontal Assessment: Based on past dental records—categorized into mild, moderate, and severe periodontitis.
2. Clinical Evaluation:

• Blood pressure
• BMI
• Blood tests: Lipid profile, fasting blood glucose

3. Questionnaire: History of cardiovascular events, smoking, physical activity, and duration of edentulism.

Statistical Analysis: Descriptive statistics, Pearson correlation, and Chi-square tests were performed using SPSS v25. A p-value <0.05 was considered significant.

Table 1: Association Between Historical Periodontal Status and Cardiovascular Risk Factors

Patients with a history of severe periodontitis had significantly higher rates of hypertension, elevated LDL, and previous cardiovascular events (p < 0.05). This supports a strong association between periodontal disease severity and cardiovascular risk (Table 1).

Table 2: Duration of Edentulism vs. Current Cardiovascular Risk Markers

A positive correlation was observed between the duration of edentulism and elevated systolic blood pressure, LDL cholesterol, and CRP levels. This suggests a cumulative systemic impact of prolonged edentulism and possibly unresolved underlying inflammation (Table 2).

Our findings confirm a significant association between prior periodontal disease and increased cardiovascular risk in complete denture wearers. This is consistent with existing literature linking oral inflammation with systemic health conditions12. The study also underscores that the risk does not diminish with the removal of teeth. Rather, chronic inflammation may persist through residual oral mucosal inflammation, microbial reservoirs, and systemic immunological memory13.

The data revealed a compelling trend: as the severity of periodontal disease increased, so did the incidence of cardiovascular risk factors. Moreover, longer durations of edentulism showed worsening cardiovascular markers. These findings support the hypothesis that tooth loss is not merely a dental issue but also an indicator of systemic health deterioration14-16.

One limitation of this study is the reliance on retrospective dental records, which may vary in accuracy. Furthermore, the cross-sectional design precludes establishing a causal relationship. Longitudinal studies would be needed to confirm these findings.

There is a strong correlation between historical periodontal status, edentulism, and increased cardiovascular risk among complete denture wearers. These findings highlight the importance of early periodontal intervention and the need for interdisciplinary collaboration between dental and medical professionals to manage patients holistically.

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