Dental Prophylaxis and Periodontal Treatment Are Protective Factors to Ischemic Stroke

Abstract

Background and Purpose-A correlation has been found between periodontal disease (PD) and stroke. This study was conducted to investigate whether dental prophylaxis and periodontal treatment reduce the incidence rate (IR) of ischemic stroke. Methods-We identified 510 762 PD cases and 208 674 non-PD subjects from January 1, 2000, to December 31, 2010. The PD cases were divided into dental prophylaxis, intensive treatment, and no treatment groups. The stroke IRs were assessed among groups during follow-up. Cox regression analysis was used after adjustment for age, sex, and comorbidities to determine the relationship between periodontal treatment and incidence of ischemic stroke. Results-The stroke IR of the non-PD subjects was 0.32%/year. In the PD group, subjects who received dental prophylaxis had the lowest stroke IR (0.14%/year); subjects with intensive treatment or tooth extraction had a higher stroke IR (0.39%/year); and subjects without PD treatment had the highest stroke IR (0.48%/year; P<0.001). After adjustment for confounders, the dental prophylaxis and intensive treatment groups had a significant lower hazard ratios for stroke than the non-PD group (hazard ratio=0.78 and 0.95; 95% confidence interval=0.75-0.81 and 0.91-0.99, respectively), whereas the PD without treatment group had a significant higher hazard ratio for stroke (1.15; 95% confidence interval=1.07-1.24), especially among the youngest (20-44) age group (hazard ratio=2.17; 95% confidence interval=1.64-2.87) after stratifying for age. Conclusions-Maintaining periodontal health by receiving dental prophylaxis and PD treatment can help reduce the incidence of ischemic stroke.

Emerging Evidence for Pathogenesis of Sporadic Cerebral Small Vessel Disease

“…45,46 Nakano et al 46 recently demonstrated that certain strains of Streptococcus mutans are potential risk factors for intracerebral hemorrhage in SHR-SPs and mice with photochemically induced middle cerebral artery occlusion. This corresponds with findings showing periodontal infections to be risk factors for stroke, 47,48 and that S. mutans is detected in 100% of samples of atherosclerotic plaques. 49 S. mutans is a major pathogen in dental caries that can cause bacteremia by dental procedures, such as tooth extraction and periodontal surgery, or even tooth brushing in daily life.…”

“…[46] недавно продемонстрировали, что некото-рые штаммы Streptococcus mutans являются потенциаль-ными факторами риска развития внутримозгового кро-воизлияние у КСГПИ и мышей с фотохимически инду-цированной окклюзией средней мозговой артерии. Это соответствует результатам, показывающим, что инфек-ции пародонта являются факторами риска развития инсульта [47,48] и что S. mutans обнаруживается в 100% образцов атеросклеротических бляшек [49]. S. mutans является одним из основных патогенов кариеса зубов и может быть причиной появления бактериемии при стоматологических процедурах, таких как удаление зуба и хирургическое вмешательство на тканях пародонта, или даже при чистке зубов в повседневной жизни [50].…”

Inflammation buccale et accidents vasculaires cérébraux ischémiques non fatals

“…Une étude récente confirme ces résultats : elle montre que le traitement de la maladie parodontale peut contribuer à réduire l'AVCI [44]. Compte tenu de la forte prévalence de la parodontite dans la population occidentale, ces données devraient faire partie de la prévention des pathologies athéromateuses dont les AVCI.…”

The Infection Hypothesis Revisited: Oral Infection and Cardiovascular Disease

“…A recent study found dental prophylaxis and periodontal treatment to be protective factors to ischaemic [93].…”