There is a strong, progressive association between tooth loss and heart disease according to a report in the latest issue of American Journal of Preventive Medicine. The researchers found that heart disease was present in 4.7% of those without tooth loss, 5.7% of those with one to five missing teeth, 7.5% of those with six to 31 missing teeth, and 8.5% of those with total tooth loss. This finding emerged after adjusting for sex, race and ethnicity, education, marital status, diabetes, smoking status, alcohol consumption, high blood pressure, high blood cholesterol and body mass index. The researchers, based at the Division of Adult and Community Health at the Centers for Disease Control and Prevention in America, analysed data from 41,891 respondents aged 40 to 79. The investigators noted that the results of this study are consistent with previous studies that link periodontal disease and tooth loss to an increased risk of atherosclerosis and heart attack. However, they said that other studies had not shown an association between oral conditions and heart disease. Catherine Okoro, the lead investigator, emphasised that the correlation between tooth loss and heart disease held even when smoking status was considered. 'Smoking has strong relationships to both tooth loss and heart disease. Nonetheless, when we stratified by age group and smoking status, a significant association remained between tooth loss and heart disease among respondents aged 40 to 59 years who had never smoked.' Okoro said the relationship between tooth loss and heart disease is of considerable public health interest because of the prevalence of both conditions in the general population. 'These results highlight the importance of health promotion counselling that includes the promotion of heart-healthy behaviours, the prevention and control of cardiovascular disease risk factors and the maintenance of good oral health,' she said.