Childhood oral health is associated with the incidence of atherosclerotic cardiovascular disease in adulthood

BACKGROUND: While adult oral health has been consistently linked to cardiovascular disease, the long-term impact of childhood oral health remains underexplored. Thus, we investigated the association between dental caries and gingivitis in childhood and the incidence of atherosclerotic cardiovascular disease (ASCVD) in adulthood. METHODS: This nationwide Danish cohort study included 568,778 individuals born between 1963 and 1972, with oral health data from the National Child Odontology Registry (1972-1987) and ASCVD outcomes from the National Patient Register (1995-2018). Dental caries and gingivitis were categorized by severity and trajectory across childhood. Cox regression models stratified by sex, education level, and type 2 diabetes status were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CI) for incident ischemic heart disease, myocardial infarction, and ischemic stroke. RESULTS: Severe childhood dental caries was associated with increased ASCVD incidence in both males (HR 1.32; 95 % CI: 1.18-1.50) and females (HR 1.45; 95 % CI: 1.25-1.68). High gingivitis scores also predicted elevated ASCVD risk (males: HR 1.21; 95 % CI: 1.10-1.32; females: HR 1.31; 95 % CI: 1.14-1.50). Disease trajectories with moderate to severe level oral disease and oral health deterioration were significantly associated with higher ASCVD incidence. CONCLUSION: Within the limitations of this study, poor childhood oral health, particularly persistent or worsening dental caries and gingivitis, is associated with an increased risk of ASCVD in adulthood. These findings highlight the potential of early oral health interventions in reducing long-term cardiovascular risk.