Loss of alveolar bone due to periodontal disease exhibits a threshold on the association with coronary heart disease

Amy C. Alman, Lonnie R. Johnson, David C. Calverley, Gary K. Grunwald, Dennis C. Lezotte, Jeri E.F. Harwood, John E. Hokanson

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Background: A number of epidemiologic studies were published that looked at the association between coronary heart disease (CHD) and periodontal disease. However, debate exists about whether this association is a true relationship or simply an example of an uncontrolled confounder. This retrospective cohort study examines the relationship between periodontal disease and CHD. Methods: Digital panoramic radiographs were used to assess alveolar bone loss (ABL) using a Schei ruler. Participants consisted of Veterans Administration (VA) patients who were eligible for dental benefits and had a digital panoramic radiograph taken at the VA Medical Center, Denver, Colorado. Information on CHD and other important clinical variables were obtained from electronic medical records. Results: The examination of the relationship between ABL and CHD revealed a significant non-linear relationship with a threshold at ̃20% bone loss with a doubling of the probability ratios of CHD compared to those at 7.5% bone loss. Conclusions: To our knowledge, this is the first study to demonstrate a non-linear relationship between ABL and CHD. A significant positive association between ABL and CHD was found at even low levels of bone loss between 10% and 20%. J Periodontol 2011;82:1304-1313.

Original languageEnglish (US)
Pages (from-to)1304-1313
Number of pages10
JournalJournal of periodontology
Issue number9
StatePublished - Sep 2011
Externally publishedYes


  • Alveolar bone loss
  • Atherosclerosis
  • Coronary disease
  • Inflammation
  • Periodontitis

ASJC Scopus subject areas

  • Periodontics


Dive into the research topics of 'Loss of alveolar bone due to periodontal disease exhibits a threshold on the association with coronary heart disease'. Together they form a unique fingerprint.

Cite this