New research suggests that gum disease carries a higher risk of causing a stroke than diabetes, and its impact is nearly the equivalent of high blood pressure as a major cause of strokes.

High blood pressure (hypertension) and diabetes (diabetes mellitus) are widely recognised as major risks which contribute to non-fatal strokes (ischemic strokes). In recent years there has been growing evidence of the link between gum disease (periodontitis) and strokes. The latest research indicates that people are twice as likely to suffer a non-fatal stroke as a result of gum disease, compared to diabetes. The data also suggests its impact is equivalent to people with high blood pressure.

The research (3), presented at the 89th International Association for Dental Research (IADR) General Session and Exhibition in San Diego last month, is another reminder of the serious impact that poor oral health poses to general health and wellbeing.

Dr Nigel Carter, Chief Executive of the British Dental Health Foundation, said: "Obesity, alcohol abuse, poor diet and smoking are generally well-known risk factors which can cause strokes. Less well-known are the risks caused by gum disease.

"This research is significant because it helps to quantify the importance of oral health compared to other risk factors. The findings are startling. The fact that high blood pressure carries a similar risk to gum disease is in itself a significant finding. The other finding which shows that gum disease nearly doubles the risk of non-fatal strokes, compared to diabetes, is totally unexpected.

"The research sends a clear message that the risks caused by poor oral health should not be overlooked or considered less important when compared to others factors.

"The good news is that poor oral health is nearly always preventable and it is important that people make caring for their teeth a top priority. Regular visits to the dentist and a simple routine of brushing teeth, twice a day for two minutes, will help to remove plaque - the cause of gum disease. It is also important to clean in between teeth using dental floss or interdental brushes", advised Dr Carter.


1. Impacts Of Periodontitis On Nonfatal Ischemic Stroke

Thursday, March 17, 2011: IADR, San Diego

H.-D. KIM, Preventive and Social Dentistry, Seoul National University-College of Dentistry, Seoul, South Korea, S.-J. SIM, Dentistry, CHA Bundang Medical Center, CHA University, Seongnam, South Korea, J.-Y. MOON, Physical Medicine and Rehabilitation, CHA Bundang Medical Center, CHA University, Seongnam, South Korea, and D.-H. HAN, Preventive and Social Dentistry, Seoul National University, Seoul, South Korea

Research Objectives: Although hypertension and diabetes mellitus (DM) have been two major causes of ischemic stroke, the association between periodontitis and ischemic strokes is still equivocal. Hence, we evaluated the association between periodontitis and nonfatal ischemic stroke and compared its impacts with those of hypertension and DM. Methods: A case-control study was performed with 143 hospitalized nonfatal ischemic stroke cases and 214 non-stroke population controls. To recruit ischemic cases, we used in-patients diagnosed by medical specialists as having nonfatal ischemic stroke using brain imaging with CT and MRI. The clinical attachment level (CAL) was assessed by a dentist using a UNC-15 manual probe. Potential confounders were determined by an interview using systematic questionnaire. We administered multivariate logistic regression analyses for evaluating the association between periodontitis and ischemic stroke. Results: After controlling for potential confounders, periodontitis was strongly associated with ischemic stroke. The odds ratio (OR) was 4.0 (95% confidence interval, 2.3 to 7.0) for periodontitis (CAL >6mm) and the association had a dose-response effect for periodontitis (CAL >5mm Percent). The OR of periodontitis was slightly less than hypertension (5.7 versus 6.1) for CAL≥6mm and slightly higher (6.7 versus 5.2) for CAL≥5mmPercent. Compared to DM, it was two times higher than that of DM (5.2-6.1 versus 2.7). The association was higher among those with obesity (32.1 versus 4.9) and normotensives (8.3 versus 4.9). Hypertension and diabetes with periodontitis (CAL≥6mm) had a synergistic interaction effect on ischemic stroke. Conclusions: Periodontitis is an evident independent risk factor for nonfatal ischemic stroke and its impact is almost same as that of hypertension and higher than that of DM.

British Dental Health Foundation