Researchers found that people with missing teeth or loss of bone and tissue surrounding their teeth may be at an increased risk for having a stroke...

New Evidence Finds an Association Between Periodontal Disease and Stroke

People missing some or all of their teeth or who have significant loss of bone and tissue surrounding their teeth may be at an increased risk for having a stroke

CHICAGO – October 10, 2006 – People missing some or all of their teeth or who have significant loss of bone and tissue surrounding their teeth may be at an increased risk for having a stroke, according to a new study that appeared in the October issue of the Journal of Periodontology (JOP). Study Abstract *

Researchers from Boston University investigated the relationship between periodontal disease and history of stroke in patients 60 years of age and older by examining the data of the Third National Health and Nutrition Examination Survey (NHANES III).

“We found that patients 60 years and older who were edentulous, partially edentulous and/or had significant clinical attachment loss were more likely to have a history of stroke compared to dentate adults without significant clinical attachment loss,” said Dr. Martha E. Nunn, Goldman School of Dental Medicine, Boston University. “However, based on the results of this study, it is unclear whether periodontal disease is an independent risk factor for stroke or simply a risk marker that reflects negative effects of risk factors common to both periodontal disease and stroke.”

Age, tobacco use, hypertension, diabetes, serum glucose, C-Reactive protein (CRP) and alcohol intake were also included as additional risk factors in this study. These confounders are independent risk factors for cardiovascular disease and if left untreated, periodontitis has been shown to have harmful effects on the control of diabetes, serum glucose levels and increases CRP levels.

Evidence continues to accumulate associating severe periodontitis with an increased risk of forming atherosclerotic plaques, which are responsible for myocardial infarction and ischemic stroke. According to past JOP studies, this relationship could be due to elevated CRP levels in patients with chronic periodontal disease.

Further investigation is needed to support periodontal treatment intervention as a means of controlling systemic inflammation. Based on findings from another study in the same issue of the Journal, CRP levels may now be reduced by periodontal treatment such as scaling and root planing in patients with severe periodontal disease. Study Abstract *

“Studies evaluating additional treatment methods such as repeated scaling and root planing or surgical treatment are needed to conclusively demonstrate that CRP can be improved by periodontal treatment,” said Preston D. Miller, DDS and AAP president. “Until science presents a definitive direction, the periodontists ultimate goal is to lead patients to the right side of health. What we do know is that eliminating periodontal infection saves teeth.”

A referral to a periodontist in your area and free brochure samples including one titled Periodontal Diseases: What You Need to Know are available by calling 800-FLOSS-EM or visiting the AAP's Web site at www.perio.org.

About the AAP

The American Academy of Periodontology is an 8,000-member association of dental professionals specializing in the prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth and in the placement and maintenance of dental implants. Periodontics is one of nine dental specialties recognized by the American Dental Association.

For more information, contact the AAP Public Affairs Department at 312/573-3242.

* EDITOR'S NOTE: Representatives of the media may contact the AAP Public Affairs Department to receive a copy of the articles The Association Between Cumulative Periodontal Disease and Stroke History in Older Adults and Effect of Periodontal Treatment on Serum C-Reactive Protein Levels” A Systematic Review and a Meta-Analysis. Abstracts of Journal of Periodontology articles are available to the public online. Full-text of studies may be accessed by AAP members and Journal subscribers or purchased online for $20.

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