Dental Prophylaxis and Periodontal Treatment Are Protective Factors to Ischemic Stroke

Author:

Lee Ya-Ling1,Hu Hsiao-Yun1,Huang Nicole1,Hwang De-Kuang1,Chou Pesus1,Chu Dachen1

Affiliation:

1. From the Department of Dentistry, Taipei City Hospital, Taipei, Taiwan (Y.-L.L.); Institute of Public Health and Community Medicine Research Center (Y.-L.L., H.-Y.H., D.-K.H., P.C., D.C.) and Institute of Hospital and Health Care Administration (N.H.), National Yang-Ming University, Taipei, Taiwan; Department of Neurosurgery (D.C.) and Department of Education and Research (H.-Y.H., N.H.), Taipei City Hospital, Taipei, Taiwan; and Department of Ophthalmology, Taipei Veterans General Hospital—Taoyuan...

Abstract

Background and Purpose— A correlation has been found between periodontal disease (PD) and stroke. This study was conducted to investigate whether dental prophylaxis and periodontal treatment reduce the incidence rate (IR) of ischemic stroke. Methods— We identified 510 762 PD cases and 208 674 non-PD subjects from January 1, 2000, to December 31, 2010. The PD cases were divided into dental prophylaxis, intensive treatment, and no treatment groups. The stroke IRs were assessed among groups during follow-up. Cox regression analysis was used after adjustment for age, sex, and comorbidities to determine the relationship between periodontal treatment and incidence of ischemic stroke. Results— The stroke IR of the non-PD subjects was 0.32%/year. In the PD group, subjects who received dental prophylaxis had the lowest stroke IR (0.14%/year); subjects with intensive treatment or tooth extraction had a higher stroke IR (0.39%/year); and subjects without PD treatment had the highest stroke IR (0.48%/year; P <0.001). After adjustment for confounders, the dental prophylaxis and intensive treatment groups had a significant lower hazard ratios for stroke than the non-PD group (hazard ratio=0.78 and 0.95; 95% confidence interval=0.75–0.81 and 0.91–0.99, respectively), whereas the PD without treatment group had a significant higher hazard ratio for stroke (1.15; 95% confidence interval=1.07–1.24), especially among the youngest (20–44) age group (hazard ratio=2.17; 95% confidence interval=1.64–2.87) after stratifying for age. Conclusions— Maintaining periodontal health by receiving dental prophylaxis and PD treatment can help reduce the incidence of ischemic stroke.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

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