The Link Between Gum Disease and Stroke

New research suggests that Gum diseases, Gingivitis and Periodontitis may increase the risk of stroke. A recent study examined whether periodontal disease is independently associated with cerebral ischemia:

Over 300 patients were examined within 7 days after experiencing an acute ischemic stroke or transient ischemic attack. All participants underwent clinical and radiographic dental examinations. The team used the individual mean clinical attachment loss measured at four sites per tooth as the primary indicator for periodontitis.

After adjustment for age, sex, number of teeth, and other factors, the risk of cerebral ischemia increased with increasing severity of periodontitis.

Subjects with severe periodontitis had a 4.3-fold increased risk of cerebral ischemia than those with mild or no periodontitis.

Active periodontal inflammation may contribute to a prothrombotic state via recurrent bacteremia, platelet activation, and elevated clotting factors, thereby increasing the risk of cardioembolism and cryptogenic stroke,’ say the authors.

Gum disease and Periodontitis are treatable – and preventable – conditions. Treating gum disease in its early stages can be key to preventing related complications – including stroke.

What Is Gum Disease?

Gum disease, also known as Periodontal disease, is an infection that damages the soft tissues and bone that supports the tooth or teeth. How does this infection typically begin? Often times, poor brushing and flossing habits allow for gum disease to creep up. Additionally, failure to attend regular dental visits can play an important role in the development of gum disease. A sticky film of bacteria (better known as plaque) forms and hardens on the teeth, denoting the beginning stages of gum disease. In more advanced stages of gum disease, the tartar that has formed can equate to sore and bleeding gums, discomfort while eating, tooth loss, and more. 

Causes

As young children, we are told by our caretakers and dentists to brush our teeth thoroughly. Thanks to that repetitive command, brushing was incorporated into our daily routines. With that said, not everyone has the same dental hygiene habits and not everyone understands just what goes on in their mouths when they fail to actively brush/floss. 

A human mouth is full of bacteria that mixes with mucus and other particles. Without consistent and thorough brushing and flossing, in addition to regular dental visits, colorless plaque takes hold of the teeth. When it hardens, it becomes “tartar” that brushing will no longer be able to clean. It is so important to take that childhood advice when it comes to avoiding the development of gum disease. 

Of course, a lack of brushing and flossing aren’t always the main blame when it comes to gum disease. It is important to note that smoking, diabetes, hormonal changes, certain medications, certain illnesses, and genetic susceptibility can all contribute to the development of gum disease. That is why dental visits are pivotal in catching gum disease and nipping it in the bud during its initial stages. 

Symptoms of Gum Disease:

• Sensitive teeth
• Bleeding, red, swollen, or sore gums
• Discomfort when chewing
• Persistent bad breath
• Loose teeth

Diagnosis

Typically, a dentist or periodontist will conduct an oral examination before diagnosing. Gums are examined for any signs of gum disease, i.e inflammation, bleeding, or swelling. Pockets are checked by “probing” to measure the pocket depth around the teeth. Pockets exceeding 3 millimeters are noted as at risk for gum disease, and pocket examination is usually painless.

In addition to the oral examination, medical history will be discussed. The medical history discussion over the history of periodontics has helped the dentistry world to formulate an interesting conclusion in regards to the relationship between gum disease and the risk of stroke. It has been found that patients who do in fact become diagnosed with gum disease are at higher risk of a stroke, or have endured a stroke. The two are heavily linked. How? Below, we will provide snippets from various studies on the matter.

Gum Disease And Stroke: What’s The Link?

There is gum bacteria known as P. gingivalis. This bacteria has been identified and confirmed in carotid arteries. Gum infection bacteria known as Streptococcus Sp DNA has been found in brain blood vessels. Gum disease was linked to strokes caused by a hardening of large arteries in the brain and also with severe artery blockages.

To put it simply, inflammation and infection is known to cause the blood to clot. If dental issues such as gum disease are left untreated, the infected buildup of tartar over time can result in a stroke. How? The buildup of bacteria, inflammation, and prolonged unhealthy oral state can eventually lead to the narrowing of important arteries. 

“Patients with gum disease had twice as many strokes due to thickening and hardening of brain arteries as patients without. Patients with gum disease were three times as likely to have a stroke involving blood vessels in the back of the brain, which controls vision, coordination and other functions.”

A Look At The Statistics:

A MedicineNet article published on February 13th, 2020, suggested these statistics that parallel statistics across a wide range of other medical platforms. Check out the statistics that MedicineNet, along with many other legitimate sources, claim regarding the association between gum disease and stroke patients:

• Patients with gum disease had twice as many strokes due to thickening and hardening of brain arteries as patients without.

• Patients with gum disease were three times as likely to have a stroke involving blood vessels in the back of the brain, which controls vision, coordination and other functions.

• Gum disease was more common in patients who had a stroke involving large blood vessels within the brain, but not among those who had a stroke due to blockages elsewhere.

Bottom Line

When it comes down to it, brushing and flossing should be looked at as more than a part of your daily routine. Brushing and flossing have both been proven to reduce the risk of heart disease and stroke, among many other general health issues. 

Continuing to thoroughly clean your teeth, in addition to attending regular dental visits serves to keep a check on more than just your dental health. Your overall health depends on it! 

As dentists, we work hard to ensure that you are healthy. If there is any detection of an issue, we will treat the issue before it escalates. In the event that you pay us a visit at a time where your condition is advanced, we will do all we can to control and treat the situation. We care about more than just your smile!

Sources:

2020. February. MedicineNet. “Why Brushing And Flossing Protect You Against Stroke.”