Periodontal disease, more commonly known as gum disease, is a global problem. Severe cases impact more than one billion people around the world, with many low- and middle-income countries lacking sufficient services to treat and prevent oral health concerns. Untreated oral health issues can lead to tooth loss and discomfort, but they can also contribute to life-threatening illness. For example, periodontal disease and dental cavities are both independently associated with incidents of ischemic stroke, the most common type of stroke. Together, they could spell disaster: A recent study found that people with both cavities and gum disease had an 86% higher stroke risk than those with healthy mouths. Below, we’ve outlined the research, which was published on October 22 in Neurology Open Access.
Teeth, Gums, and Ischemic Stroke Risk
The study focused specifically on the risk of ischemic strokes, the most common form of stroke, which occur when a clot or blockage restricts oxygen to the brain. But what, exactly, is the connection between dental hygiene and stroke risk?
Mapping the Connection Between Oral Health and Stroke Risk
The study is the culmination of 20 years of research, during which the research team worked to develop a holistic picture of participant health. The team studied 5,986 adults with an average age of 63, none of whom had experienced a stroke at the time of the study’s initiation. At the beginning of the process, each participant underwent thorough dental exams. After the exams, participants were grouped into three categories: “healthy mouth,” “gum disease only,” and “gum disease with cavities.”
Participants were then monitored for 20 years. During that time, researchers logged which participants suffered strokes. Among the participants with healthy mouths, 4% had a stroke. In comparison, 10% of those with both gum disease and cavities experienced a stroke. After accounting for other variables, including age and smoking, the researchers found that study participants with both gum disease and cavities had roughly an 86% greater risk of stroke compared with the participants with healthy mouths.
How Dental Disease Drives Deadly Inflammation
The connection between dental disease and stroke risk likely involves inflammation. Periodontal disease is, at its core, a chronic inflammatory condition that is caused by bacterial colonization in the mouth. Dental cavities may also involve inflammatory pathways, with bacteria breaking down the teeth and leading to infection and inflammation. The researchers write that these “inflammatory mediators trigger a chronic systemic inflammatory response, contributing to atherosclerosis,” or the kind of vascular disease seen in stroke patients. On a similar note, the researchers also discovered that people with both gum disease and cavities had a 36% higher risk of cardiovascular events when compared with the healthy-mouth group— another potential indicator of vascular distress.
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Ultimately, the study revealed a connection between dental disease and stroke risk, but it did not establish a direct cause-and-effect relationship. The study was further limited by the fact that researchers were unable to regularly assess participants’ oral health over the course of the 20-year study period. “The observed association between regular dental care and reduced stroke risk may reflect not only a potential biological effect — through the reduction of periodontal inflammation and systemic immune activation — but also broader behavioral and sociodemographic factors,” the researchers noted. It did, however, reinforce the importance of dental hygiene in relation to overall health.
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