Tooth Loss as a Predictor of Coronary Artery Disease Severity in Patients with Acute Myocardial Infarction: A Prospective Cross-Sectional Study

<b>Background:</b> Tooth loss reflects cumulative oral inflammation and has been associated with adverse cardiovascular outcomes. This study evaluated the relationship between the number of missing permanent teeth and the angiographic severity of coronary artery disease (CAD) in patients with acute myocardial infarction (AMI). <b>Methods:</b> In this prospective cross-sectional study, 200 consecutive AMI patients underwent coronary angiography and standardized dental assessment during hospitalization. Tooth loss was categorized as 1-10, 11-20, or 21-32 missing teeth. CAD severity was defined by the number of major epicardial arteries with significant stenosis. Multivariate logistic regression adjusted for age, sex, smoking status, diabetes, obesity, dyslipidemia, and hypertension. <b>Results:</b> Increasing tooth loss was associated with more extensive CAD. The mean number of affected vessels rose from 1.58 ± 0.79 in the 1-10 tooth-loss group to 2.06 ± 0.99 in the 21-32 group (<i>p</i> = 0.014). Tooth loss correlated with CAD severity (r = 0.19, <i>p</i> = 0.007). After adjustment, >20 missing teeth remained an independent predictor of multivessel disease (OR = 1.84; 95% CI: 1.01-3.34; <i>p</i> = 0.047). ROC analysis showed modest discrimination (AUC = 0.61). <b>Conclusions:</b> Extensive tooth loss independently correlates with greater angiographic CAD severity in AMI patients. Dental status may serve as a simple, non-invasive clinical marker of cardiovascular disease burden.