Gum Disease and Stroke WHAT'S THE CONNECTION BETWEEN GUM DISEASE AND STROKE?
Recent studies have associated a link between periodontal disease, cardiovascular disease (CVD) and stroke. Gum disease and its role in overall general health have been reported for many years, including most recently in the 2000 U.S. Surgeon General's Report on "Oral Health in America."
Periodontal disease is one of the most common diseases, affecting about 10 percent of all adults, and one-third of adults after the age of 50. Periodontal disease is prevalent, especially in late middle-age when CVD and stroke are also most common. Periodontal diseases are bacterial infections associated with bacteremia (a presence of a bacteria in the blood), inflammation and a strong immune response. These may represent significant risk factors for the development of coronary heart disease, myocardial infarction and stroke.
Clinical experts in oral infections and systemic conditions gathered in April 2001 in Bethesda, Maryland, to discuss the emerging science relating periodontal diseases to chronic systemic diseases and conditions such as cardiovascular disease and stroke. "Periodontal-Systemic Connection: A State-of-the-Science Symposium" was organized by the American Academy of Periodontology and the National Institute of Dental and Craniofacial Research.
One clinical article titled, "Periodontal disease and risk of cerebrovascular disease. The First National Health and Nutrition Examination Survey and its follow-up study" "Archives of Internal Medicine 2000) discussed during the symposium, did not find significant association between periodontitis and stroke. However, the researchers discussed the limitations of the First National Health and Nutrition Examination Survey (NHANES) database regarding periodontal assessments. The researchers indicated that the assessments were quite crude compared with assessments in more recent studies. This could result in misclassification bias that might diminish the strength of the periodontitis and stroke connection. The inability to monitor changes in periodontal disease at the beginning of the study, as well as individuals who might have sought treatment for their periodontal disease during the course of the study, may further bias the periodontal, CVD and stroke connection. The outcomes of these first generation studies have stimulated further interest and focus on future studies on the possible mechanisms involving infection with periodontal bacteria and the inflammatory response.
Researchers believe that even a modest effect of periodontal disease on the incidence of CVD and stroke makes this exposure an important public health concern.
