The association between the nature and timing of dental visits and c-reactive protein levels

Abstract

Objectives<br>Evidence suggests an association between dental disease and cardiovascular disease (CVD). C-reactive protein (CRP), an inflammatory marker, has been implicated as a risk factor for CVD, and dental disease can affect CRP levels. Our study examined the relationship between the timing and nature of dental visits and CRP.<br><br>Methods<br>Using data from the US-based 1999-2000,2001-2002, and 2003-2004 National Health and Nutrition Examination Surveys, we examined the relationship between time since and reason for most recent dental visit and CRP among adults ?20 years old. Participants were excluded if they were pregnant at the time of the survey, did not take part in the examination component of the survey, or were missing covariates for a logistic regression model: age, sex, race, BMI, HbA1c, WBC count, CRP measure, time since and reason for last dental visit, smoking status, cholesterol-lowering medication use, and history of asthma, cancer, rheumatoid arthritis, chronic bronchitis, or recent illness. A dichotomous elevated CRP measure was used, defined as CRP >0.30 mg/dL. Time since last dental visit was categorized as <6 months, 6 months to <1 year, 1 year to <2 years, and 2+ years ago; respondents who reported never visiting a dentist were placed in the 2+ years category.<br><br>Results<br>A greater proportion of the normal (?0.30 mg/dL) CRP group last visited a dentist <6 months ago (P=0.0460), and last visited the dentist for a "preventive" visit (P<0.0001), while a greater proportion of the elevated CRP group last visited the dentist for a "symptom-driven" visit (P<0.0001). Regression model results demonstrated that preventive visits are associated with a reduced likelihood of elevated CRP (OR=0.722; P=0.0120), regardless of the time since last visit.<br><br>Conclusions<br>Given the apparent association between risk of elevated CRP and reason for the last dental visit, medical and dental providers should consider interventions specifically around appropriate dental care.