Gum Disease In Men Is Linked To Stroke And Ischemic Attack

By Margarita Nahapetyan

There is a link between periodontitis and cerebrovascular disease in younger men, new medical research has established.

According to the background information in a research article describing the study, periodontitis as an inflammatory disease of the gums, and cerebrovascular disease is a stroke or transient ischemic attack (TIA). In a new study, researchers found that there is a relationship between the life-threatening cardiovascular disease, and in particular, ischemic stroke, and bone loss caused by periodontitis. Men under the age of 65 years who have the gum disease are most at risk of having a stroke, compared to older men, the findings concluded.

Periodontitis commonly occurs when bacteria start to grow on the surface of teeth. Gingivitis can be a precursor to a diagnosis of the gum disease, which over a period of time can lead to severe bone loss below the gum line and even the loss of teeth.

The investigators Thomas Dietrich of the University of Birmingham School of Dentistry, and Elizabeth Krall of the Boston Veteran Affairs and the Boston University School of Dental Medicine, examined the data from 1,137 men who participated in the Veteran Affairs Normative Aging and Dental Longitudinal Study in Boston. An ongoing study started in the 60s and included healthy male volunteers who were given full-mouth X-rays and periodontal probing on every tooth every 3 years for an average follow-up time of 24 years.

The results revealed that there was a significant association between bone loss due to periodontitis and the incidence of stroke or transient ischemic attack, independent of cardiovascular risk factors. The experts said that the association was much stronger among male participants who were younger than 65 years old. According to the researchers, there are several possible explanations for the association observed in the study. The team said that there could be direct or indirect impact of the periodontal infection and the inflammatory response, or some individuals may have an elevated pro-inflammatory susceptibility that could lead to both cerebrovascular disease and periodontal disease.

The study demonstrated that only bone loss due to periodontitis, which would be an indicator of a history of periodontal disease, not probing depth, which would be an indicator of a current inflammation, was linked to the risk of developing cerebrovascular disease. The Dietrich and Krall said that the stronger association in younger men observed in the current and other studies may indicate that there is a pro-inflammatory susceptibility in some men that is reflected in periodontal destruction at a younger age.

Researchers noted that if periodontitis triggered heart disease, it should be considered as an important risk factor, given its relatively high prevalence and the strength of the association in younger men. They also noted that there could be another possibility that people with periodontitis may pay less attention to their overall health, for example, they may not take required medications as regularly as older people do.

The authors said that more larger-scale epidemiologic studies using molecular and genetic approaches in various populations are needed in order to determine the strength of the relationship between periodontitis and cerebrovascular disease and to figure out what is its biologic basis.

The study findings are published in the journal Annals of Neurology.