The relationship between dental disease and cerebral vascular accident in elderly United States veterans

Ann Periodontol. 1998 Jul;3(1):161-74. doi: 10.1902/annals.1998.3.1.161.


We report here information obtained from a cross-sectional study of 401 veterans, who were at least 60 years of age, which showed that several dental/oral conditions can be significantly associated with the diagnosis of a cerebral vascular accident (CVA), when included in a multivariate logistic regression model with and without many of the known risk factors for a CVA. The dental findings relative to the prevalence of dental caries and periodontal disease were not distinctly different between the subjects with and without a CVA in the bivariate analysis. A higher stimulated salivary flow was negatively associated with a CVA in the multivariate models. The plaque index and oral hygiene habits relating to brushing, flossing, and frequency of having teeth cleaned by a dentist/hygienist were significantly associated with a CVA in the bivariate analysis. Among these oral hygiene parameters, *needing help in brushing one's teeth" and the reported annual visit to the dentist/hygienist for teeth cleaning remained significant in the multivariate models involving the dependent-living subjects. The need for help in brushing one's teeth could reflect the fact that many subjects had reduced manual dexterity as a result of the CVA and required this extra care. However, the finding that those dependent-living individuals who reported that they did not have their teeth cleaned at least once a year were 4.76 times more likely to have had a CVA, suggests that a pattern of oral neglect might be associated with developing a CVA. The implications of this in terms of an intervention strategy for CVA warrants further consideration. However, caution is recommended because the data were obtained from a convenience sampling of older veterans and may not be generalizable to other populations.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Alcohol Drinking
  • Cerebrovascular Disorders / epidemiology
  • Cerebrovascular Disorders / etiology*
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • DMF Index
  • Dental Care for Aged / statistics & numerical data*
  • Dental Plaque Index
  • Female
  • Humans
  • Logistic Models
  • Long-Term Care
  • Male
  • Michigan / epidemiology
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Oral Hygiene / statistics & numerical data*
  • Periodontal Diseases / complications*
  • Periodontal Index
  • Smoking
  • Statistics, Nonparametric
  • Tooth Loss / complications
  • Veterans / statistics & numerical data
  • Xerostomia / complications