Poor Oral Health in Childhood Linked to Increased Cardiovascular Risk

A tooth cavity and bleeding gums are common among Danish children—and researchers now connect these issues to health problems that can persist long after a child loses their baby teeth. A new study from the University of Copenhagen concludes that children with multiple tooth cavities or severe gingivitis have a markedly higher incidence of stroke, heart attack, and coronary artery disease as adults.

Study Details and Findings

Researchers analyzed data from 568,000 children born in the 1960s and 70s, utilizing records from the Danish Health Authority’s National Child Odontology Registry. This data was then compared with cardiovascular disease data from the National Patient Register, tracking individuals up to 2018 when they reached adulthood. The findings were published in the International Journal of Cardiology.

The analysis revealed striking patterns: children with numerous tooth cavities had up to a 45% higher incidence of cardiovascular disease in adulthood compared to those with few cavities. Children with severe gingivitis faced up to a 41% higher incidence. Even as these figures varied by sex, the trend remained consistent across both groups, with the risk increasing as dental problems worsened throughout childhood.

The Role of Inflammation

While the study establishes a statistical correlation, researchers haven’t definitively determined the cause-and-effect relationship. However, inflammation is a leading theory.

“We suspect that exposure to high levels of inflammation in the form of gum disease and dental caries already in childhood may influence how the body later responds to inflammation,” explains Nikoline Nygaard, a postdoctoral researcher at the University of Copenhagen’s Department of Odontology and one of the study’s authors.

This theory aligns with other research demonstrating a link between periodontitis and cardiovascular disease. The World Heart Federation has issued a consensus report stating strong evidence exists that periodontitis increases the risk of cardiovascular disease. The report suggests that bacteria from gum disease can trigger systemic inflammation, potentially accelerating atherosclerosis and cardiovascular disease.

Connection to Type 2 Diabetes

Nygaard and her colleagues have as well explored the relationship between oral health and type 2 diabetes. A separate study, published in Acta Diabetologica, found that children with severe gum disease had up to an 87% higher incidence of type 2 diabetes, while those with multiple tooth cavities had a 19% higher incidence.

Lifestyle Factors and Prevention

Researchers acknowledge that lifestyle factors likely play a significant role in the increased incidence of both cardiovascular disease and type 2 diabetes. They adjusted their data to account for educational level, as higher education is generally associated with healthier lifestyles and longer lifespans. However, even after this adjustment, a marked incidence of cardiovascular disease remained.

Despite not establishing a direct causal link, the study highlights the potential for prevention. Childhood dental caries is a widespread global disease, and both cavities and gum disease are largely preventable with thorough tooth brushing.

“In Denmark, 20% of children and young people account for 80% of all registered dental disease. If we can identify markers indicating who is at higher risk of various diseases later in life, we can tailor preventive efforts to those groups. And that could have long-term health benefits well into adulthood,” says Merete Markvart, associate professor at the Department of Odontology at the University of Copenhagen and co-author of the study.

Markvart suggests that mandatory registration of gingivitis on the National Child Odontology Register, similar to the current registration of tooth cavities, could be beneficial.

“It’s not that you can solve cardiovascular disease by treating children’s teeth. But if we target our efforts towards specific groups, you can nudge many people in the right direction simply by improving their oral health,” Markvart adds.

Study Methodology

The study utilized data from the National Child Odontology Register (SCOR) on all children born between 1963 and 1972 who had at least two SCOR registrations—a total of 568,778 individuals. This data was compared with National Patient Register data from 1995–2018, covering the period when participants were aged between 30 and 56. This was a cohort study, following a defined group over time to examine the impact of oral health on disease incidence. Results were adjusted for educational level and the presence of type 2 diabetes.