J Epidemiol Community Health 67:381-382 doi:10.1136/jech-2013-202481
  • Editorial

A sober look at the links between oral and general health

  1. Carlos Quiñonez2
  1. 1Department of Epidemiology and Public Health, University College London, London, UK.
  2. 2Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Georgios Tsakos, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK; g.tsakos{at}
  • Received 15 February 2013
  • Accepted 20 February 2013
  • Published Online First 13 March 2013

The article ‘Oral Health as a Risk Factor for Mortality in Middle-Aged Men: the Role of Socioeconomic Position and Health Behaviours’ by Sabbah et al.1 adds to the continuing interest placed on the associations between oral and general health. This is an old observation and at least a century long debate, when the theory of focal sepsis linked oral sepsis and dental extractions with endocarditis. Yet in recent years, this field of research has considerably intensified, and there is now a plethora of evidence for different oral–general health links. For example, periodontal (gum) disease has been consistently associated with atherosclerosis and cardiovascular disease markers,2 while number of teeth,3 and even oral health behaviours such as tooth brushing,4 have been shown to be independent predictors of mortality. These are only examples of a growing body of literature linking oral health, mostly tooth loss and periodontal disease, with a number of different health conditions particularly in the middle and older adulthood.

In oral health and oral healthcare policy circles, the interest in the links between oral and general health is related to the desire to position oral health–oral healthcare as important in the general health–healthcare policy environment. This may be because, historically, oral health has been …