Number of teeth is independently associated with ischemic stroke: A case-control study.

Poor oral health has been suggested as a potential risk factor for the occurrence of cardiovascular events. The present study aimed to test the hypothesis that the number of permanent natural teeth (NT) is independently associated with the occurrence of ischemic stroke (IS) or transient ischemic attack (TIA) in a southern Brazilian population. This case-control study enrolled 458 subjects, 229 hospital patients diagnosed with IS or TIA (cases) and 229 patients with no history of cardiovascular disease (controls). NT was assessed through a head and neck multidetector computed tomography angiography (MDCTA) and panoramic radiographs. The participants were matched by age and sex. Sociodemographic and medical confounding variables were obtained from the hospital charts and through a structured questionnaire. Multivariate logistic regression analysis were carried out to estimate the association between NT and the occurrence of IS or TIA. The mean age was 58.37 ± 10.75 years, with 46.7% males. Adjusted analyses showed an independent association between IS or TIA and hypertension (OR = 6.34, 95%CI = 3.93-10.24), smoking (OR = 4.70, 95%CI = 2.76-7.99) and NT (lower quartile: ≤7 teeth) (OR = 5.59, 95%CI = 2.88-10.86). The number of permanent natural teeth was inversely and independently associated with the occurrence of IS or TIA in this population. Present findings suggest a gradient effect on the association between oral health and IS.

Associação entre saúde bucal e acidente vascular encefálico isquêmico (AVEI) - uma revisão da literatura / Association between oral health and ischemic stroke (IS) - a literature review

A associação entre saúde bucal e desfechos de saúde geral vem sendo estudada de modo crescente nas últimas décadas, com ênfase na relação entre doenças inflamatórias crônicas bucais e doenças cardiovasculares (DCV) de origem aterosclerótica. OBJETIVO: revisar a literatura, atualizando os conhecimentos sobre a associação entre parâmetros de saúde bucal (doença periodontal (DP), periodontite apical (PA) e perda dentária) e a ocorrência de acidente vascular encefálico isquêmico (AVEI). METODOLOGIA: foram pesquisadas as seguintes bases eletrônicas, sem restrições de idiomas ou data: PubMed/ MEDLINE, LILACS, Scielo e ISI Web of Science e Schoolar Google, além de buscas manuais. Estudos realizados em animais ou in vitro, relatos e séries de casos foram excluídos. RESULTADOS: a presente revisão identificou e incluiu 11 estudos clínicos observacionais avaliando a associação entre diferentes indicadores de saúde bucal e AVEI, além de uma meta-analise sobre o assunto. Nenhum estudo de intervenção foi identificado. CONCLUSÃO: a evidência disponível, oriunda de estudos observacionias, sugere que as principais doenças inflamatórias crônicas bucais (DP e PA) estão associadas de modo independente com DCV de origem aterosclerótica. A relação entre DP e AVEI parece consistente, porém há carência de estudos analisando a associação entre AVEI e outros parâmetros de saúde bucal, especialmente cárie e PA. Até o momento, uma relação de causalidade entre DP, PA e AVEI não pode ser confirmada ou rejeitada, em face à ausência de estudos de intervenção. Futuros estudos deverão contribuir para o esclarecimento dos mecanismos biológicos que embasam a associação entre as doenças crônicas bucais e o AVEI.

The association between oral health and general health has been under study for decades, with emphasis on the relationship between chronic oral inflammatory diseases and atherosclerotic cardiovascular diseases (ACVD). OBJECTIVE: to review the literature, updating the knowledge about the association between oral health (periodontal disease (PD), apical periodontitis (AP) and tooth loss) and the occurrence of ischemic stroke (IS). METHODOLOGY: the following electronic databases were searched, without language or date restrictions: PubMed/MEDLINE, LILACS, Scielo, ISI Web of Science and Schoolar Google, as well as manual searches. Studies in animals or in vitro, reports and series of cases were excluded. RESULTS: the present review identified and included 11 clinical observational studies evaluating the association between different indicators of oral health and IS, and one meta-analysis on the field. No interventional studies were identified. CONCLUSION: the available evidence from observational studies suggests that the main chronic oral inflammatory diseases (PD and PA) are independently associated with ACVD. In addition, the relationship between PD and IS seems consistent, but there is a lack of studies analyzing the association between IS and other oral health parameters, such as caries and AP. To now, a causal relationship between DP, PA and IS cannot be confirmed or rejected, considering the lack of interventional studies on the area. Future studies should contribute to the comprehension of the biological mechanisms underlying the association between the main chronic oral diseases and IS.