Stroke is caused by the build-up of arterial plaque and the narrowing of cerebral blood vessels.
Gum disease is a chronic bacterial infection, associated with inflammation, that affects the soft, hard structures that support teeth.
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Gum disease, inflammation, atherosclerosis and arterial stiffness, chain associations
Because inflammation seems to play a major role in the development and worsening of atherosclerosis and arterial stiffness, the researchers looked at whether gum disease is associated with atherosclerosis of the brain vessels.
A first study focused on the association of periodontal disease with atherothrombotic stroke: the researchers examined 265 patients, aged on average 64 years, 56% of men, having suffered a stroke between 2015 and 2017 and investigated the presence of the disease gums. This first study finds that:
- strokes due to intracranial atherosclerosis are 2 times more common in patients with gum disease;
- participants with gum disease have a 3-fold risk of stroke involving blood vessels in the back of the brain, a brain area involved in vision, coordination and other vital bodily functions;
- gum disease is more common in patients with stroke involving large blood vessels in the brain, but not more common in patients with stroke due to blockage of blood vessels outside the skull .
This first study therefore confirms the association between certain types of stroke and periodontal disease.
A second study looked, “in the other direction” what was the impact of periodontal disease on intracranial atherosclerosis: the researchers followed 1,145 participants in the DARIC study (Dental Atherosclerosis Risk in Communities), who had not undergone ‘Stroke, average age 76 years and 45% of men. Periodontal examinations were used to identify and assess the severity of gum disease. The study shows that:
- participants with gingivitis or gum inflammation are 2 times more likely to have narrowing of the cerebral arteries due to the buildup of atheroma plaque vs. participants without gum disease;
- after adjustment for possible confounders, including age, high blood pressure and high cholesterol, participants with gingivitis have a 2.4-fold increased risk of serious obstruction of the cerebral arteries.
This second study confirms an increased risk of blockage of the cerebral arteries in case of gingivitis.
Next step : check that treating the gums reduces the risk of stroke. Researchers suggest that treating gum disease in combination with other risk factors for stroke may reduce the severity of artery plaque buildup and the narrowing of cerebral blood vessels and therefore the risk of d stroke. However, the cause and effect relationship between gum disease and risk of stroke remains to be demonstrated.
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