Background/Purpose: Cardiovascular Disease (CVD) is the main cause of death in patients with Rheumatoid Arthritis (RA), and a significant portion of CVD events occur in patients without traditional risk factors. Substantial evidence supports that periodontitis is a risk factor for mortality from coronary heart disease and cerebrovascular disease, as well as all-cause mortality. The association between tooth loss in RA patients and all-cause mortality and cardiovascular mortality needs further study.

Methods: This study included 582 participants (221 males, 361 females; age range 20-85 years) from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2004. Weighted multivariate Cox proportional hazards models were used to assess the association between the number of teeth in RA patients and all-cause mortality and cardiovascular mortality.

Results: Over a median follow-up of 16.8 months, a decrease in the number of permanent teeth was associated with factors such as age, Body Mass Index（BMI, Poverty Income Ratio (PIR), Education, and Chronic Obstructive Pulmonary Disease (COPD) (all P< 0.05) (Table 1). 264 participants died, with 82 deaths due to CVD. After adjusting for age, smoking (never, former, and current), ethnicity, education, annual family income, Healthy Eating Index 2015 scores, BMI, hypertension, diabetes, COPD, and cancer, participants with more than 8 missing teeth had the highest risk of all-cause mortality (Hazard Ratio [HR] 4, 95% Confidence Interval [CI] 1.66, 9.67) compared to those with no missing teeth, while those with complete tooth loss had the highest risk of cardiovascular mortality (HR 39.01, 95% CI 5.52-274.89) (Table 2&Figure).

Conclusion:  This study is the first to find a dose-dependent relationship between the number of teeth in RA patients and all-cause mortality and CVD mortality. The number of teeth is a suitable indicator of oral health, indicating an association between oral health and CVD in RA patients.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-association-between-the-number-of-teeth-and-all-cause-as-well-as-cardiovascular-mortality-among-patients-with-ra-nhanes-from-1999-to-2004/