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Background  Few studies have reported associations between periodontitis and cardiovascular disease ( CVD ) risk in older women, which is the objective of the present investigation.    Methods and Results  Participants were 57 001 postmenopausal women ages 55 to 89 years (mean 68 years; >85% 60 and older) who were enrolled (1993–1998) in the Women's Health Initiative Observational Study, and were without known  CVD  when history of periodontitis and edentulism was assessed by questionnaire at study Year‐5 (1998–2003). There were 3589 incident  CVD  events and 3816 total deaths during a mean follow‐up of 6.7 years. In multivariable analysis, periodontitis was not associated with  CVD  events, but was associated with higher total mortality (hazard ratio ( HR )=1.12, 95%  CI : 1.05–1.21). Edentulism was associated with higher age‐ and smoking‐adjusted risks of  CVD  ( HR =1.42, 95%  CI : 1.27–1.59) and mortality ( HR =1.47, 95%  CI : 1.32–1.63). Further adjustment eliminated the association with  CVD , but mortality remained significantly increased ( HR =1.17, 95%  CI : 1.02–1.33). Stratification on age, race‐ethnicity, smoking, and diabetes mellitus yielded comparable results; however, edentulism was more strongly associated with  CVD  in women reporting ≥1 dental visit ( HR =1.57) compared with <1 visit ( HR  1.03, interaction  P =0.004) annually.    Conclusions  In community‐dwelling older women, edentulism was associated with increased risks of  CVD  and total mortality, and presence of periodontitis, which is more prevalent than edentulism, was associated with 17% higher mortality rate. These findings suggest that improving periodontal condition of the general population could reduce overall mortality.

History of Periodontitis Diagnosis and Edentulism as Predictors of Cardiovascular Disease, Stroke, and Mortality in Postmenopausal Women