Tooth loss and periodontal disease may increase the risk of ischemic stroke, according to a report in Stroke, a journal of the American Heart Association. Ischemic strokes result from a blockage in an artery leading to the brain. They are the most common type of stroke.
In the study, men who had fewer than 25 teeth when they entered the study had a 57% higher risk of ischemic stroke than those with 25 or more teeth.
The link between ischemic stroke and periodontal disease, adds to the
growing body of evidence that infection plays a role in stroke and heart
disease. However, the new study presents a surprising finding about
The association of ischemic stroke with tooth loss persisted even after study parameters were controlled for periodontal disease history. This could reflect severe periodontal disease in the extracted teeth.
Another unexpected and unexplained finding was that the association between tooth loss and stroke risk was higher among nonsmokers than among smokers. Smoking tobacco is a risk factor for both ischemic stroke and periodontal disease. This finding may lend support to the argument that the association between tooth loss and stroke is not all due to smoking.
Researchers also found that the risk of stroke was mainly related to the number of missing teeth at entry into the study, rather than teeth lost recently during the follow-up phase. This is possibly because only a few teeth were lost during follow-up or may imply that tooth loss takes many years to impact ischemic stroke risk. The study is the first to examine the timing of tooth loss and the effect on stroke risk.
Periodontal disease, tooth loss and ischemic stroke share about a dozen risk factors, including age, smoking, and diabetes.
Researchers documented 349 ischemic strokes in the entire study group. Compared to men with 25 to 32 teeth, those with 17 to 24 teeth had a 50% higher risk of stroke. Men with 11 to 16 teeth had a 74% higher risk and men with 10 or fewer teeth had a 66% higher risk of stroke compared to men with the most teeth.
Researchers also studied whether the association between tooth loss and ischemic stroke could partly be the differences in diet, such as the amount of fruits and vegetables consumed. Typically, when people loose teeth, they may eat fewer fruits and vegetables. The reduced nutritional intake might affect their stroke risk.
Supplementation Slows Tooth Loss
Calcium and vitamin D supplementation is known to slow the rate of age-related bone loss at various skeletal sites. But it has not been established that the same supplementation affects the jawbone (alveolar bone), which some experts believe becomes fragile with aging. Because the jawbone loses its mass faster than other bones, it is a major contributor to tooth loss. Now scientists have found strong evidence that tooth loss in the elderly can be minimized if people get their recommended dietary allowance of both calcium and vitamin D.
The scientists looked at 145 healthy volunteers older than 65 who completed a 3-year, randomized, placebo-controlled trial, as well as a 2-year follow-up after the calcium and vitamin D supplements used in the study were stopped. Teeth were counted at 18 months and 5 years. During the course of the study, 13% of those who took the supplements lost one or more teeth, but more than twice that number (27%) in the placebo group (no supplement intake) lost teeth in the same period.
During the 2-year follow-up period, study participants were divided into two groups. The first group had a daily calcium intake above 1,000 mg. and the other group had daily intake below 1000 mg. The higher daily calcium intake group had half the risk of tooth loss as the group that consumed less than 1,000 mg. of calcium.
Approximately 33% of the U.S. population, aged 65 and older, are edentulous (have no teeth), according to
Oral Health in America: A Report of the Surgeon General, published in 2000. Tooth loss imposes psychological, social, and physical impairment on those affected.
It has also been estimated that older adults are now getting cavities at twice the rate of teenagers.
This most recent study finding may lead to an expanded array of treatment and greater emphasis on nutrition education and the use of supplements. If the nutritional factors of tooth loss can be further confirmed, utilizing
supplements to help maintain healthy teeth and gums would be a cost effective way of improving tooth retention.