Link Found Between Periodontal Disease and Stroke

People missing teeth or who have significant loss of bone and tissue surrounding their teeth may be at an increased risk for having a stroke, according to a new study.

Researchers from the Goldman School of Dental Medicine at Boston University (MA, USA) investigated the relationship between periodontal disease and history of stroke in patients 60 years of age and older by examining the data of the third National Health and Nutrition Examination Survey (NHANES III). Because 1,563 of the 5,123 subjects in the study were edentulous (toothless) and periodontal disease is a major cause of tooth loss, it was necessary to account for edentulousness in the statistical analysis to avoid bias. Age, tobacco use, hypertension, diabetes, serum glucose, C-reactive protein (CRP), and alcohol intake were also included as additional risk factors in the study.

Completely edentulous elderly adults and partially edentulous--teeth in one arch--elderly adults with appreciable clinical periodontal attachment loss were found to have significantly more likelihood of having had a history of stroke compared to dentate adults--teeth in both arches--without appreciable clinical periodontal attachment loss. The study was published in the October 2006 issue of the Journal of Periodontology.

"We found that patients 60 years and older who were edentulous, partially edentulous and/or had significant clinical attachment loss were more likely to have a history of stroke compared to dentate adults without significant clinical attachment loss,” said lead author Dr. Martha E. Nunn. "However, based on the results of this study, it is unclear whether periodontal disease is an independent risk factor for stroke or simply a risk marker that reflects negative effects of risk factors common to both periodontal disease and stroke.”

Periodontitis has been shown to have harmful effects on the control of diabetes, serum glucose levels, and increased CRP levels, and evidence continues to accumulate associating severe periodontitis with an increased risk of forming atherosclerotic plaques. This relationship could be due to elevated CRP levels in patients with chronic periodontal disease.



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