Study Links Brain Attack to Oral Health
The Harvard Focus - February 7, 2003
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Caring for your teeth could reduce your chance of developing an ischemic stroke, according to a new study by HSPH researchers. Kaumudi Joshipura, Hsin-Chia Hung, Alberto Ascherio, and their colleagues found that men with dental disease - tooth loss, periodontal disease, or both - could have more than a 50 percent greater risk of suffering an ischemic stroke than those with healthy gums and teeth. Previous studies had suggested that there might be a link between poor dental health and cardiovascular disease, but they tended to lump all kinds of stroke - fatal, nonfatal, ischemic, and total - together. To tease out the correlation with ischemic stroke, in particular, Joshipura, associate professor of oral health policy and epidemiology; Alberto Ascherio, associate professor of nutrition and epidemiology; and colleagues analyzed data from more than 41,000 male health professionals enrolled in the Health Professionals' Follow-up Study. After correcting for common risk factors such as smoking, diabetes, age, obesity, and alcohol use, they found that men with 24 teeth or fewer had a 57 percent higher risk of developing ischemic stroke than those with 25 teeth or more. Men with periodontal disease had a 33 percent higher risk. "It is too early to say whether the association is causal or not. In the meantime, it does not hurt to take better care of your teeth," said Joshipura. Yet there are plausible mechanisms for an association between periodontal disease and ischemic stroke. "Periodontal disease is an inflammatory disease so it would lead to an increase in inflammatory markers, not just within the gums, but also systemically in the blood," Joshipura said. "Markers like C-reactive protein, von Willebrand factor, or fibrinogen are associated with increased heart disease risk." In addition, tooth loss might require people to change their diet, which could affect cardiovascular health, though this has been hard to demonstrate. "There may be components we are not measuring, like how food is cooked," she said. Misia Landau, Harvard Focus |