A new study has established a link between periodontitis history and cerebrovascular disease in men.
Background information in a research article describing the study, published in Annals of Neurology, describes periodontitis as an inflammatory disease of the gums, and cerebrovascular disease as a stroke or transient ischemic attack (TIA).
The article further reveals that this is the first prospective cohort study to use clinical measures of periodontitis to evaluate the association between this disease and the risk of cerebrovascular disease.
Thomas Dietrich of the University of Birmingham School of Dentistry, and Elizabeth Krall of the Boston VA and the Boston University School of Dental Medicine, analysed data from 1,137 men in the VA Normative Aging and Dental Longitudinal Study, an ongoing study begun in the 1960s with healthy male volunteers from the greater Boston area.
A trained periodontist conducted dental exams every three years that included full mouth X-rays and periodontal probing at each tooth. Follow-up lasted an average of 24 years.
The researchers observed that there was a significant association between periodontal bone loss and the incidence of stroke or TIA, independent of cardiovascular risk factors.
They say that the association was much stronger among men younger than 65 years old.
According to them, there are several possible pathways that could explain the association found in the study.
The team say that there could be direct or indirect effects of the periodontal infection and the inflammatory response, or some people may have an increased pro-inflammatory susceptibility that could contribute to both cerebrovascular disease and periodontal disease.
The study showed that only periodontal bone loss, which would indicate a history of periodontal disease, not probing depth, which would indicate current inflammation, was associated with the incidence of cerebrovascular disease.
The researchers say that the stronger association in younger men seen in this and other studies may indicate a pro-inflammatory susceptibility in some men that is reflected in periodontal destruction at a younger age.
They note that if periodontitis caused cerebrovascular disease, it could be an important risk factor, given its relatively high prevalence and the strength of the association in younger men.
They also see the possibility that people with periodontitis may pay less attention to health in general, for example, they may not take medications as regularly.
The authors conclude: "Large epidemiologic studies using molecular and genetic approaches in various populations are necessary to determine the strength of the association between periodontitis and cerebrovascular disease and to elucidate its biologic basis."