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Heart failure is a risk factor for poor oral health in the UK Biobank

https://doi.org/10.1007/s00392-025-02625-4

Martin Berger (Aachen)1, M. Rizk (Aachen)2, J. Kern (Aachen)2, M. Wolf (Aachen)3, S. Wolfart (Aachen)2, J. Jankowski (Aachen)4, K. Marx-Schütt (Aachen)1, N. Marx (Aachen)1

1Uniklinik RWTH Aachen Med. Klinik I - Kardiologie, Angiologie und Internistische Intensivmedizin Aachen, Deutschland; 2Klinik für Zahnärztliche Prothetik und Biomaterialien Aachen, Deutschland; 3Klinik für Kieferorthopädie Aachen, Deutschland; 4Uniklinik RWTH Aachen Institut für Molekulare Herz-Kreislaufforschung (IMCAR) Aachen, Deutschland

 

Background

Cardiovascular diseases are known to be associated with oral health. However, evidence on the impact of heart failure (HF) on oral health remains limited.

 

Aims 

To investigate the influence of heart failure on oral health in the UK Biobank

Methods and results 

Data on oral health was available in 559.460 patients in the UK biobank, with 32.677 patients diagnosed with HF, according to ICD10. Dental diseases were more common among HF patients (54% vs. 41%, p < 0.001), with the presence of dentures being the most common reason for compromised oral health (37% vs. 18%, p < 0.001). After adjusting for biomarkers, cardiovascular, and socioeconomic risk factors in a stepwise logistic regression model, HF remained a significant predictor of poor oral health (OR 1.20, 95% CI 1.17–1.23, p < 0.001; see Table 1). To further investigate the pathological basis of this association, an exploratory analysis assessed established prognostic markers in HF for their impact on oral health. Among these, only high-sensitivity C-reactive protein (hs-CRP) was found to be significantly associated with poor oral health in HF patients (OR 1.01 per unit increase, 95% CI 1.01–1.02, p < 0.001). Other prognostic markers in HF, including NT-proBNP, left ventricular ejection fraction (LVEF), and kidney function (eGFR), showed no significant association with oral health outcomes. These findings suggest that systemic inflammation may link HF and compromised oral health.

Conclusion
Our study highlights HF as a risk factor for poor oral health in the UK Biobank cohort. Exploratory analyses suggest systemic inflammation may play a central role in the relationship between HF and oral health.

Table 1: Stewise-adjusted logistic regression model for the risk of poor oral health in patients with heart failure

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