How strong is the link between periodontitis and stroke?

Area of Science:

• Medical Research
• Epidemiology
• Cardiovascular Science

Background:

• Periodontal disease is a chronic inflammatory condition affecting the gums and supporting structures of the teeth.
• Cerebrovascular accidents (strokes) represent a significant global health burden.
• Emerging evidence suggests a potential link between systemic inflammation and cardiovascular events.

Purpose of the Study:

• To systematically review and meta-analyze observational studies investigating the association between periodontitis and the risk of cerebrovascular accidents (stroke).
• To quantify the risk of stroke in individuals with periodontitis compared to those without.
• To assess the heterogeneity and quality of included studies.

Main Methods:

• A comprehensive literature search was conducted across multiple databases (PubMed, Scopus, Web of Science, etc.) up to September 2018.
• Observational studies in humans examining the link between periodontitis and stroke risk were included.
• Data were extracted and analyzed using meta-analysis techniques, calculating odds ratios (OR) and risk ratios (RR) with 95% confidence intervals.

Main Results:

• Ten studies with a low risk of bias were included, involving a total of 80 to 15,792 participants.
• Individuals with periodontitis were found to be twice as likely to suffer a stroke (OR 2.31) and specifically an ischaemic stroke (OR 2.72).
• Cohort studies indicated a higher risk of stroke (RR 1.88) in individuals with periodontitis, with minimal heterogeneity observed.

Conclusions:

• The meta-analysis provides strong evidence for an association between periodontal disease and an increased risk of stroke.
• Further prospective studies are needed to explore the relationship between periodontal disease severity, stroke severity, and the impact of periodontal treatment on stroke outcomes and survival.