Dental treatment procedures for periodontal disease and the subsequent risk of ischaemic stroke: A retrospective population-based cohort study

J Clin Periodontol. 2019 Jun;46(6):642-649. doi: 10.1111/jcpe.13113. Epub 2019 May 7.

Abstract

Aim: To investigate the association between specific dental therapy for periodontal disease and the risk of ischaemic stroke.

Materials and methods: We conducted a population-based cohort study that used data from the Taiwan National Health Insurance Research Database 2005 for the period of 2000-2013. Our observations focused on patients with the diagnoses of gingivitis or periodontitis with and without specific treatment and subsequent incidence of ischaemic stroke. Dental care services include dental scaling, intensive treatment (subgingival curettage and root planing) and tooth extraction. Multivariate Cox regression analysis was used to estimate the hazard ratios and corresponding 95% confidence intervals (95% CI).

Results: Compared with those in the gingivitis cohort, patients with periodontitis have a higher risk of ischaemic stroke and a lower survival rate of stroke over the 10-year follow-up period. After integrative dental care, both dental scaling and intensive treatment, the risk was reduced, especially in patients with periodontitis, while patients with periodontal disease may have an increased risk of stroke after tooth extraction therapy.

Conclusions: Our study showed that periodontitis is a risk factor for ischaemic stroke. Both dental scaling and intensive treatment for periodontal disease are associated with a lower risk of further ischaemic stroke events.

Keywords: dental scaling; gingivitis; ischaemic stroke; periodontitis.

MeSH terms

  • Brain Ischemia*
  • Cohort Studies
  • Dental Care
  • Dental Scaling
  • Humans
  • Periodontal Diseases*
  • Retrospective Studies
  • Stroke*
  • Taiwan