Childhood Oral Infections: A Modifiable Risk Factor for Adult CVD?

boy at dentist
Childhood oral infections may be a modifiable risk factor for adult cardiovascular disease.

Childhood oral infections may be a modifiable risk factor for adult cardiovascular (CV)  disease, according to study results published in JAMA Network Open.

Early life exposure to CV risk factors such as high blood pressure, increased body mass index, a proatherogenic lipid profile, and smoking have been associated with the development of atherosclerosis in adulthood. Although severe forms of common chronic oral infections or inflammation are associated with increased CV risk in adults, the role of childhood oral infections in CV risk is not known. Therefore, researchers in Finland conducted a cohort study of 755 participants derived from an ongoing prospective study in which they underwent a clinical oral examination in 1980 at age 6, 9, or 12 years and then a clinical CV follow-up in adulthood in 2001 at age 27, 30, or 33 and/or in 2007 at age 33, 36, or 39. They found that 33 children (4.5%) had no sign of oral infections whereas 41 (51.6%) had 1 sign, 127(17.4%) had 2 signs, 278 (38.3%) had 3 signs, and 248 (34.1%) had 4 signs.

The cumulative exposure to risk factors increased with the increasing number of oral infections both in childhood and adulthood, and childhood oral infections, including signs of periodontal disease, caries, or both, were associated with adulthood carotid artery intima-media thickness. Thus, the presence of any sign of oral infection in childhood was associated with increased intima-media thickness. Of note,  the associations were more obvious in boys and the associations were independent of CV risk factors.

The investigators concluded, “This study, in which participants were followed up for 27 years, suggests that oral infections in childhood are associated with the subclinical carotid atherosclerosis in adulthood.”

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Pussinen PJ, Paju S, Koponen J, et al. Association of childhood oral infections with cardiovascular risk factors and subclinical atherosclerosis in adulthood. JAMA Network Open. 2019;2(4):e192523.