Abstract
Cardiovascular disease (CVD) is a global health concern; however, its association with the posterior occlusal contact remains unexplored. This study investigated the association between posterior occlusal contact and CVD risk in a large Japanese cohort and examined whether the loss of posterior occlusal contact in individuals with at least 20 teeth was a distinct CVD risk factor. Using Japanese health insurance claims data from 1,209,997 adults aged ≥ 40 years without prior CVD history (April 2016-March 2022), participants were categorized using the Eichner classification to assess posterior occlusal contact. Over an average follow-up period of 36.2 months, 51,471 participants developed CVD. Compared with individuals with full occlusal contact (Eichner A), those with reduced contact (Eichner B and C) demonstrated significantly higher CVD risks, with hazard ratios of 1.25 (95% confidence interval [CI]: 1.19-1.32) and 1.31 (95% CI: 1.17-1.46), respectively. In a subgroup analysis of participants with ≥ 20 teeth, reduced occlusal contact from Eichner A2 to B2 was associated with an increased risk of CVD, especially in those aged 40-59 years. These findings suggest that reduced posterior occlusal contact may contribute to increased CVD risk, emphasizing the importance of preserving natural occlusal support for CVD prevention.