Oral health and subclinical vascular changes: a cross-sectional ultrasonographic study

Periodontitis and dental caries are prevalent oral diseases with potential systemic effects. Recent studies highlight a possible link between oral health and cardiovascular diseases via systemic inflammation and endothelial dysfunction. This study investigates the impact of periodontitis and dental caries on cardiovascular health by assessing their associations with carotid intima-media thickness (CIMT) and carotid arterial stiffness (CAS). In this cross-sectional study, participants were classified to contrast two distinct oral inflammatory conditions: caries-free periodontitis and caries-affected periodontally healthy controls. Periodontal examinations and Decayed, Missing, and Filled Teeth (DMFT) scoring were performed. CIMT and CAS parameters, including distensibility coefficient (DC), compliance coefficient (CC), alpha stiffness index, beta stiffness index, and pulse wave velocity (PWV), were assessed using fully automated QIMT and QAS software based on high-resolution B-mode ultrasonography. Statistical analyses compared oral health parameters with cardiovascular markers. The periodontitis group exhibited significantly higher CIMT values, along with reduced DC and CC and increased β-stiffness index and PWV compared with periodontally healthy controls (p < 0.05). Periodontitis stage demonstrated significant correlations with CIMT and multiple arterial stiffness parameters, indicating a severity-dependent vascular effect. However, in age-adjusted linear regression models, periodontal group status was not independently associated with CIMT or carotid arterial stiffness parameters, whereas age remained a strong predictor across all vascular outcomes (all p < 0.001). Regarding dental caries, no significant associations were observed between total DMFT score and CIMT or arterial stiffness parameters. Although the missing teeth component showed a significant unadjusted correlation with CIMT, this association was no longer significant after adjustment for age and sex. Although unadjusted analyses suggested worse CIMT and carotid stiffness profiles in periodontitis, age-adjusted models indicated that age was the dominant determinant of vascular parameters in this cohort. Dental caries showed no independent association with CIMT or carotid stiffness. The use of fully automated QIMT and QAS software enabled a comprehensive and operator-independent assessment of both structural and functional carotid properties, representing a key methodological contribution of this study.