Good dental health ‘cuts stroke risk’

By Joanna Lyford, Senior medwireNews Reporter

Good dental health, including prophylaxis of periodontal disease, is associated with a reduced risk for ischemic stroke, results of a large retrospective cohort study indicate.

The study used data from the Taiwanese National Health Insurance program, a compulsory and universal program that includes 99% of the population.

Of a total of 719,436 individuals included in the database between 2000 and 2010, 15,141 (2%) developed ischemic stroke and 510,762 (71%) were diagnosed with periodontal disease.

The overall incidence rate (IR) of stroke was 0.25% per year, but this rose to 0.32% among people who were not diagnosed with periodontal disease.

Of the remainder, all of whom were diagnosed with periodontal disease, those who received dental prophylaxis had the lowest risk for stroke, at an IR of 0.14% per year; those who underwent intensive treatment or tooth extraction had a higher risk, at an IR of 0.39% per year; and people who were diagnosed but not treated for periodontal disease had the highest risk, at an IR 0.48% per year.

In further analyses that stratified people by age, gender, and comorbidity, the risk for stroke among those with periodontal disease was lowest in people who received prophylactic treatment, intermediate in those who underwent intensive treatment or extraction, and highest in those who were not treated.

This pattern was reinforced by regression analysis, which identified receipt of dental prophylaxis and intensive treatment as significant protective factors against stroke, with adjusted hazard ratios (HR) of 0.78 and 0.95, respectively.

Conversely, patients who had periodontal disease but were not treated had an increased risk for stroke, with an HR of 1.15. This association was true across all age groups but became more pronounced with younger age, with HRs of 2.17, 1.19, and 1.13 in people aged 20-44 years, 45-64 years, and older than 65 years, respectively.

These results "show that periodontal disease is an important risk factor for ischemic stroke, and periodontal disease patients who received treatment have a lower risk of stroke, especially among young subjects," write Dachen Chu (Taipei City Hospital, Taiwan) and co-authors in Stroke.

This in turn "suggests that periodontal disease must be treated to reduce the risk of stroke," say Chu et al.

They conclude: "Because periodontal disease can be prevented and treated as long as people improve their oral hygiene and attend regular dental checkups and prophylaxis, those who already have periodontal disease should seek treatment to alleviate tissue inflammation and thereby reduce the incidence of ischemic stroke."

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