Masticatory Performance and Mortality in Individuals with Cardiovascular Diseases: A Population-Based Prospective Study

BackgroundThe relationship between functional tooth units (FTU) and cardiovascular diseases (CVD) risk remains understudied. This study is to investigate the association between masticatory performance, measured by FTU, and CVD incidence and CVH, and mortality among individuals with CVD using data from the National Health and Nutrition Examination Survey (NHANES). MethodsMasticatory function was measured by FTU, CVD was determined by the self-reported questionnaire, CVH was assessed using the American Heart Associations Lifes Simple 7 (LS7), Lifes Essential 8 (LE8), and Lifes Crucial 9 (LC9). CVD mortality was determined from the National Death Index. Weighted logistic, linear regression and cox proportional hazards models were used to evaluate the associations between FTU and CVD incidence, CVH and mortality. ResultsHigher FTU was associated with a reduced risk of CVD. Participants with FTU scores of 9-12 had a 46% reduced risk of CVD compared to those with FTU scores of 0-3. FTU was also positively correlated with better CVH scores in LS7, LE8 and LC9. In the mortality analysis, those with FTU of 9-12 was associated with a 42%, 39% and 71%% reduction in all-cause, CVD- and cancer related mortality. The other masticatory function parameters and sensitivity analyses confirmed these relationships. ConclusionPreservation of masticatory function, measured by FTU, is associated with decreased CVD prevalence, improved CVH and reduced mortality in individuals with CVD. These findings suggest that the maintenance of optimal masticatory function may play a protective role in reducing CVD incidence and mortality. Clinical relevanceO_ST_ABSWhat is New?C_ST_ABSThis study provides novel insights into the association between masticatory function, assessed by functional tooth units (FTU), and cardiovascular disease (CVD) outcomes in individuals with CVD. It demonstrates that higher FTU scores are linked to a significantly lower risk of CVD, improved cardiovascular health (CVH) scores, and reduced mortality, including CVD- and cancer-related deaths. Importantly, this is one of the first studies to show the potential role of masticatory function as a modifiable factor in cardiovascular health and mortality reduction in a large, nationally representative cohort. What Are the Clinical Implications?The findings highlight the importance of maintaining masticatory function as part of a comprehensive approach to CVD prevention and management. Clinicians should consider the role of oral health, specifically masticatory function, in improving cardiovascular health outcomes and reducing mortality risk in CVD patients. These results suggest that enhancing masticatory function may be a simple, yet effective intervention for reducing CVD incidence and mortality, emphasizing the need for oral health preservation in clinical practice, particularly among individuals with cardiovascular disease.