Association between Oral Health and the Risk of Lacunar Infarction in Japanese Adults

Abstract

Background: Poor oral health is associated with an increased risk of dementia in the elderly. One possible pathway linking these two phenomena is lacunar infarction, a potential cause of dementia. An association between poor oral health and an increased risk of ischaemic stroke has been recognised through the oral infection-inflammation pathway. However, little is known about whether poor oral health is associated with the progression of lacunar infarction. Objective: We examined the association between variables related to oral health and lacunar infarction, as detected by magnetic resonance imaging (MRI). Methods: A total of 110 subjects (52 men, 58 women), aged 27-76 years, who visited our periodontology clinic participated in this study. The subjects underwent dental radiography, periodontal examinations and brain MRI. One experienced specialist in cardiovascular disease and one experienced neurosurgeon determined the number of lacunar infarctions on brain MRI. Periodontologists performed clinical periodontal examinations. Variables related to oral health were determined from the radiographs by an oral radiologist. Information on the subjects' lifestyles and disease histories were obtained using a structured questionnaire and confirmed by clinical records. Adjacent categories logit regression analysis with backward elimination was used to determine variables associated with three groups based on the number of lacunar infarctions. Results: Of the 110 subjects, 61 had lacunar infarctions. Nineteen had multiple (≥7) lesions. Aging (p = 0.0004), increased time spent in physical activity per day (p = 0.042), the presence of hypertension (p = 0.006), the absence of hyperlipidaemia (p = 0.045), the presence of diabetes mellitus (p = 0.025) and low alveolar bone height (p = 0.026) were significantly associated with an increased number of lacunar infarctions in the final regression model. The significance of hyperlipidaemia and alveolar bone height disappeared in an unadjusted model. An increased pocket depth, which indicates current periodontal disease progression, tended to be associated with an increased number of lacunar infarctions (p = 0.058). This tendency did not disappear in an unadjusted model. Conclusion: Our results suggest that lacunar infarction may be associated with current periodontal disease in Japanese adults.

Periodontitis as a risk indicator and predictor of poor outcome for lacunar infarct

“…A previous study demonstrated that PPD was increased in LI, but failed to demonstrate a relationship between clinical periodontal parameters and the presence of LI (Taguchi et al. ). Similarly, although our patients with LI showed worse periodontal conditions in terms of past (i.e., CAL) and current PD (i.e., FMBS and PPD), none of them were significantly associated with a higher risk of LI.…”

Association between Carotid Artery Calcification and Periodontal Disease Progression in Japanese Men and Women: A Cross-Sectional Study

“…A 2014 meta-analysis reported that a periodontal disease increases the incidence of cerebrovascular disease [ 25 ]. In Japan, Taguchi et al reported a significant association among the number of lacunar infarctions, a type of cerebral infarction, and ABL [ 26 ]. However, a cohort study found no such significant association [ 27 ].…”

Introductory Chapter: Future Prospect of Licorice, Popular Crude Drug and Food Sweetener

“…Recent report suggests an association between oral health and the risk of lacunar infarction [12]. Tooth-blushing and myofunctional therapy stimulate the secretion of saliva [13,14].…”