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Poor oral health and inflammatory, haemostatic and cardiac biomarkers in older age: Results from two studies in the UK and USA

Lookup NU author(s): Eftychia KotroniaORCiD, Professor Sheena Ramsay



This is the authors' accepted manuscript of an article that has been published in its final definitive form by The Gerontological Society of America, 2021.

For re-use rights please refer to the publisher's terms and conditions.


Background: We examined the association of objective and subjective oral health markers with inflammatory, haemostatic and cardiac biomarkers in older age. Methods: Cross-sectional analyses were based on the British Regional Heart Study (BRHS) comprising British men aged 71-92 years (n=2147), and the Health, Aging and Body Composition (HABC) Study comprising American men and women aged 71-80 years (n=3075). Oral health markers included periodontal disease, tooth count, dry mouth. Inflammatory biomarkers included C-reactive protein (CRP), interleukin-6 (IL-6) in both studies, and tissue plasminogen activator (t-PA), von Willebrand Factor (vWF), fibrin D-dimer, high sensitivity Troponin T (hsTnT) and N-terminal pro-brain natriuretic peptide (NTproBNP) only in the BRHS. Results: In both studies, tooth loss, was associated with the top tertile of CRP – odds ratios (95%CI) are 1.31 (1.02-1.68) in BRHS; and 1.40 (1.13-1.75) in the HABC Study, after adjusting for confounders. In the HABC Study, cumulative (≥3) oral health problems were associated with higher levels of CRP (OR (95%CI) =1.42 (1.01-1.99)). In the BRHS, complete and partial tooth loss were associated with haemostatic factors, in particular with the top tertile of fibrin D-dimer (OR (95%CI) = 1.64 (1.16-2.30) and 1.37 (1.05-1.77) respectively). Tooth loss and periodontal disease were associated with increased levels of hsTnT. Conclusions: Poor oral health in older age, particularly tooth loss, was consistently associated with some inflammatory, haemostatic and cardiac biomarkers. Prospective studies and intervention trials could help understand better if poor oral health is causally linked to inflammatory, haemostatic and cardiac biomarkers.

Publication metadata

Author(s): Kotronia E, Wannamethee SG PhD, Papacosta AO, Whincup PH, Lennon LT, Visser M, Kapila YL, Weyant RJ, Ramsay SE

Publication type: Article

Publication status: Published

Journal: The Journals of Gerontology: Series A

Year: 2021

Volume: 76

Issue: 2

Pages: 346-351

Print publication date: 01/02/2021

Online publication date: 19/04/2020

Acceptance date: 09/04/2020

Date deposited: 20/04/2020

ISSN (print): 1079-535X

ISSN (electronic): 1758-535X

Publisher: The Gerontological Society of America


DOI: 10.1093/gerona/glaa096


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Funder referenceFunder name
R03 DE028505-02
R592/0717Dunhill Medical Trust