12/23/2009 - Articles

Keeping Your Mouth Healthy May Help Prevent Stroke

By: Sheri McGregor


Think the way you care for your teeth and gums affects only your mouth? Think again.

Think the way you care for your teeth and gums affects only your mouth? Think again. In study results recently published in the Archives of Internal Medicine, researchers at the University of Buffalo have shown that people with severe gum disease have twice the risk of a cerebrovascular accident (CVA) - otherwise known as a stroke.

In other recent studies, the connection between oral health and the risks of heart attack have been well documented. Now, with this new study, it seems the risk of stroke is even stronger than heart attack for persons with gum disease.

The results of this study were determined over a nearly thirty-year span starting in the early 1970s. Sample groups of individuals were examined for baseline gum health and their records later checked for association with CVA. The sample used for the latest findings included nearly ten thousand individuals between the ages of 25 and 75. These individuals were categorized into four groups: no periodontal disease, gingivitis, periodontitis, and toothless. Gingivitis is an inflammation of the gums and considered a mild form of periodontal disease. Periodontitis is a more severe infection, which involves the gums, the membranes at the base of the teeth and the supporting bone beneath. The study group was comprised of men and women, blacks and non-blacks. Final study results demonstrate that periodontal disease was associated with increased risk of cerebrovascular disease in all groups.

Using the baseline oral health determined many years ago, study colleagues compiled information on the occurrence of stroke among participants. During this follow-up survey, health records and death certificates showed that subjects earlier determined to have periodontitis had a two-fold increase for CVA (stroke caused by clogged arteries). In the study, strokes caused by hemorrhages in the brain don't appear to be related to gum health.

The findings were consistent with several previous studies. In one such study, patients under 50 with cerebral infarction (a part of the brain dying due to lack of oxygen caused by CVA) had poorer periodontal health than a randomly selected group of healthy persons who were the same age.

Although research doctors know little about the relationship between cerebrovascular health and gum disease, they believe periodontitis increases the risk of stroke in the same way other studies have shown poor oral health to increase heart disease. Bacteria from gum pockets enter the bloodstream and may produce a systemic inflammatory response. Increased bacteria in the bloodstream causes the production of more clotting factors than normal, and increased plaque in the arteries - factors we know are associated with strokes due to cerebrovascular impairment. Researchers have found periodontal bacteria in plaque taken from the arteries of stroke victims.

Although doctors feel more studies are needed to explore the cause and effect relationship between periodontitis and risks of developing CVA, the association seems clear.

Your dentist can measure your current periodontal status and advise you on improving your oral health. Flossing has long been the standard guide for maintaining healthy gums, because it enables you to clean between the teeth and deep into the gum line where food becomes trapped and harmful bacteria multiply. See your dentist for an assessment of your oral health and talk to him about products and activities that can enhance not only your smile but your entire well-being.


Periodontal disease and risk of cerebrovascular disease. T. Wu, M. Trevisan, RJ. Genco,  et al., Arch Intern Med, 2000, vol. 160, pp. 2749--2755


"Beat your risk factors" by Charlotte Libov

Created on: 07/02/2001
Reviewed on: 12/23/2009

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