ObjectivesThe relationship between carotid artery calcification (CAC) and tooth loss was investigated and its association with inflammatory mediator levels was evaluated.Subjects and methodsNinety–two participants were examined for health and periodontal status. Panoramic radiographs were obtained for CAC identification. C‐reactive protein (CRP), intercellular cell adhesion molecule‐1 (ICAM–1), and vascular cell adhesion molecule‐1 (VCAM–1) levels were measured.ResultsFifteen participants (16.3%) had CAC, 12 (80.0%) of whom were female. Mean age of participants with CAC was 55.3 ± 12.2 years, while that of participants without CAC was 48.9 ± 9.4 years. Median number of tooth loss in participants with CAC was 11, whereas that of individuals without CAC was 3 (P = 0.008). Age and presence of CAC were associated with the number of tooth loss, independent of health status (β = 0.452, P = <0.001 and β = 0.257, P = 0.005). Based on CRP levels, 10 participants (71.4%) were at intermediate risk of coronary heart disease (range, 1.0–2.3 μg ml−1), while four participants (28.6%) were at low risk (<1.0 μg ml−1). CRP, ICAM–1, or VCAM–1 levels were not significantly related to the presence of CAC or tooth loss.ConclusionsPatients with higher tooth loss have a greater prevalence of CAC. Patients with CAC should be referred for medical consultation.