Periodontal inflammation: Independent risk factor for ischemia strokes

Periodontal Inflammation: Independent Risk Factor for Ischemia Strokes Photo: Dental Health: a family affair /

ROCKVILLE, Md., April 16, 2013 — There is a surprising association between periodontal inflammation and strokes.

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Following heart disease and cancer, strokes are the fourth leading cause of death in the United States. The vast majority of these strokes are ischemia strokes, which is often the result of the narrowing of the artery that feeds blood into the brain from the heart and lungs, and the blood clotting in this narrowed artery.

Strokes can occur in a person of any race, of either gender, and at any age in life. Often strokes occur in those over the age of 55, with each subsequent year after having an increased risk of occurrence. There are certain risk factors associated with having a stroke prior to the 55th year of life, and these are divided into lifestyle and medical factors.

Ischemia strokes are characterized by factors such as high cholesterol, tobacco and alcohol use, and obesity. These lifestyle factors are the key as they are often controllable and thus preventable, and it is within these that periodontal inflammation falls.

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Recent information suggests active periodontal inflammation behavies as an increased risk factor for strokes in people younger than 55. Periodontal inflammation occurs in the tissues surrounding the teeth, generally as a result of extremely poor hygiene. It is marked by an increasing loss of the supporting structure of the teeth resulting in the loosening, and then loss, of teeth. The scholarly consensus is that periodontal inflammation does in fact increase the likeliness of stroke risk in younger people, and there are two separate lines of evidence supporting this claim.

One recent study by the American Heart Association supports the theory of periodontal inflammation increasing risk of stroke. The study found periodontal inflammation as a strong risk factor for ischemia strokes, but that edentulousness (possessing no teeth) produced no increased risk.

Gingivitis was found to be strongly associated with ischemia and may even act as the more important risk factor when compared to periodontitis. The theory that gingivitis poses more risk arose when periodontal inflammation was tested in conjunction with severe gingivitis.

Gingivitis itself is a visible representation of the status of inflammation found, and acute infections have been found to be a trigger for ischemia strokes.

Gingivitis is often thought of as following poor health care post-stroke, but there was no evidence of time elapsed being a factor as a cause of gingivitis post-stroke in patients examined in this case study.

While the levels of gingivitis infection vary with each person, making the strength of gingivitis as a risk factor subsequently vary, periodontal disease is a chronic condition. Periodontal disease also suffers from both periods of quiescence and of exacerbations.

It is during the high-points of an exacerbation that most acute ischemia strokes occur, suggesting further that the presence of a periodontal disease can significantly increase the likelihood of an ischemia stroke occurring.

Periodontal disease does pose itself as an independent risk factor for ischemia strokes through large-artery atherosclerosis and should be considered a lifestyle risk factor. Both periodontitis and gingivitis are treatable conditions that can be prevented by routinely visiting the dentist and making correct lifestyle choices, and as they pose a threat of ischemia strokes to young individuals should be  factors.

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Ali Forghani, DDS

My name is Dr Ali Reza Forghani, and I currently run the Modern Smiles Dental Practice in Rockville, Maryland.  I graduated from New York University College of Dentistry, after receiving my Bachelor of Science degree from the University of Maryland.  My aim is to provide comprehensive dental care for all of my patients, and I believe that education and the use of modern methods and technologies is the best way to achieve this.


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