DOI QR코드

DOI QR Code

The Relationship between Oral Health and Stroke in Adults Based on the 6th (2015) Korea National Health and Nutrition Examination Survey

  • Shin, Hae-Eun (Department of Preventive Dentistry, School of Dentistry, Kyungpook National University) ;
  • Park, Eui-Jung (Department of Dental Hygiene, Daegu Health College) ;
  • Jung, Eun-Kyung (Department of Dental Hygiene, Ulsan College) ;
  • Kim, Eun-Kyong (Department of Dental Hygiene, College of Science & Technology, Kyungpook National University) ;
  • Cho, Min-Jeong (Department of Preventive Dentistry, School of Dentistry, Kyungpook National University)
  • Received : 2017.11.02
  • Accepted : 2018.01.17
  • Published : 2018.02.28

Abstract

Stroke is the second cause of death worldwide, although the survival period is increasing after the occurrence of stroke, severe physical disability is caused with aftereffect. Oral inflammation is not limited to the oral cavity, it can cause malignant changes in other tissues and organs. In previous studies, we confirmed the relationship between tooth loss and stroke due to periodontal inflammation. The purpose of this study was to investigate the relationship between oral health and stroke such as oral hygiene behavior, tooth loss and periodontal disease among Korean adults over 40 years of age. This study was analyzed using the 6th Korea National Health and Nutrition Examination Survey (KNHANES) data. A total of 3,389 adults over 40 years of age were analyzed as final subjects. Socioeconomic statuses and oral health status was analyzed using a complex sample analysis technique. Logistic regression was used to analyze the relationship of oral health and stroke, and 95% confidence intervals were computed using SPSS. When the prevalence of stroke according to oral hygiene behavior was checked, the prevalence of strokes was lower in subjects who had a lot of brushings per day and subjects who used oral hygiene products (p<0.05). The risk of stroke was 2.17 times (95% confidence interval, 1.43~3.28) higher in the group with less than 19 remaining teeth, but it was not statistically significant as a result of adjusting for age and sex, income level, education level, drinking and smoking (p>0.05). Loss of teeth was found to be associated with the risk factor of stroke. Therefore, loss of teeth due to periodontal disease is an additional issue that should be considered as a risk factor for stroke.

References

  1. Kim JM, Lee CH, Yang HS, Shin HS: Effect of posterior leaf spring on standing balance in patients with hemiplegia. Phys Ther Korea 8: 63-69, 2001.
  2. World Health Organization: Global Health Observatory (GHO) data. Top 10 causes of death. Retrieved December 28, 2017, from http://www.who.int/gho/mortality_burden_disease/causes_death/top_10/en/(2017, January).
  3. Statistics Korea: Causes of death statistics 2015. Statistics Korea Publishing, Daejeon, pp.8-17, 2016.
  4. Towfighi A, Saver JL: Stroke declines from third to fourth leading cause of death in the United States: historical perspective and challenges ahead. Stroke 42: 2351-2355, 2011. https://doi.org/10.1161/STROKEAHA.111.621904 https://doi.org/10.1161/STROKEAHA.111.621904
  5. Pow EH, Leung KC, Wong MC, Li LS, McMillan AS: A longitudinal study of the oral health condition of elderly stroke survivors on hospital discharge into the community. Int Dent J 55: 319-324, 2005. https://doi.org/10.1111/j.1875-595X.2005.tb00330.x https://doi.org/10.1111/j.1875-595X.2005.tb00330.x
  6. Iwasaki M, Sato M, Yoshihara A, Ansai T, Miyazaki H: Association between tooth loss and medical costs related to stroke in healthy older adults aged over 75 years in Japan. Geriatr Gerontol Int 17: 202-210, 2017. https://doi.org/10.1111/ggi.12687 https://doi.org/10.1111/ggi.12687
  7. Donnan GA, Fisher M, Macleod M, Davis SM: Stroke. Lancet 371: 1612-1623, 2008. https://doi.org/10.1016/S0140-6736(08)60694-7 https://doi.org/10.1016/S0140-6736(08)60694-7
  8. Broderick J, Connolly S, Feldmann E, et al.: Guidelines for the management of spontaneous intracerebral hemorrhage in adults. Stroke 38: 2001-2023, 2007. https://doi.org/10.1161/STROKEAHA.107.183689 https://doi.org/10.1161/STROKEAHA.107.183689
  9. Woo D, Sauerbeck LR, Kissela BM, et al.: Genetic and environmental risk factors for intracerebral hemorrhage: preliminary results of a population-based study. Stroke 33: 1190-1196, 2002. https://doi.org/10.1161/01.STR.0000014774.88027.22 https://doi.org/10.1161/01.STR.0000014774.88027.22
  10. Seok SJ, Lee J: Comparison of stroke risk factors between middle aged and elderly patients. J Korean Gerotol Nurs 19: 13-27, 2017. https://doi.org/10.17079/jkgn.2017.19.1.13 https://doi.org/10.17079/jkgn.2017.19.1.13
  11. Mansour TR, Alam Y, Dahbour L, Alnemari A, Jumaa M, Schroeder JL: Streptococcus mutans: a potential risk factor in recurrent hemorrhagic stroke. Cureus 9: e1264, 2017. https://doi.org/10.7759/cureus.1264 https://doi.org/10.7759/cureus.1264
  12. Kim CS, Choi YK: Survey of adults' perceptions of the association between chronic diseases and oral health. J Dent Hyg Sci 17: 12-19, 2017. https://doi.org/10.17135/jdhs.2017.17.1.12 https://doi.org/10.17135/jdhs.2017.17.1.12
  13. Cheon SH, Jeong SH: Association between perceived periodontal status and sexual function in adult men. J Dent Hyg Sci 14: 132-139, 2014.
  14. Kim SJ, Choi JS: The associated factors with xerostomia in patients with systemic diseases. J Dent Hyg Sci 13: 386-392, 2013.
  15. Mantovani A, Allavena P, Sica A, Balkwill F: Cancer-related inflammation. Nature 454: 436-444, 2008. https://doi.org/10.1038/nature07205 https://doi.org/10.1038/nature07205
  16. Kinane DF, Riggio MP, Walker KF, MacKenzie D, Shearer B: Bacteraemia following periodontal procedures. J Clin Periodontol 32: 708-713, 2005. https://doi.org/10.1111/j.1600-051X.2005.00741.x https://doi.org/10.1111/j.1600-051X.2005.00741.x
  17. Lockhart PB, Brennan MT, Thornhill M, et al.: Poor oral hygiene as a risk factor for infective endocarditis-related bacteremia. J Am Dent Assoc 140: 1238-1244, 2009. https://doi.org/10.14219/jada.archive.2009.0046 https://doi.org/10.14219/jada.archive.2009.0046
  18. Kebschull M, Demmer RT, Papapanou PN: "Gum bug, leave my heart alone!"--epidemiologic and mechanistic evidence linking periodontal infections and atherosclerosis. J Dent Res 89: 879-902, 2010. https://doi.org/10.1177/0022034510375281 https://doi.org/10.1177/0022034510375281
  19. Ford PJ, Yamazaki K, Seymour GJ: Cardiovascular and oral disease interactions: what is the evidence? Prim Dent Care 14: 59-66, 2007. https://doi.org/10.1308/135576107780556806 https://doi.org/10.1308/135576107780556806
  20. Mattila KJ, Pussinen PJ, Paju S: Dental infections and cardiovascular diseases: a review. J Periodontol 76(11 Suppl): 2085-2088, 2005. https://doi.org/10.1902/jop.2005.76.11-S.2085 https://doi.org/10.1902/jop.2005.76.11-S.2085
  21. Linden GJ, Lyons A, Scannapieco FA: Periodontal systemic associations: review of the evidence. J Periodontol 84(4 Suppl): S8-S19, 2013. https://doi.org/10.1902/jop.2013.1340010 https://doi.org/10.1902/jop.2013.1340010
  22. Kim EK, Kim MS, Lee HK: A study on the oral health and oral health related quality of life of stroke patients in a rehabilitation ward: a pilot study. J Dent Hyg Sci 16: 127-133, 2016. https://doi.org/10.17135/jdhs.2016.16.2.127 https://doi.org/10.17135/jdhs.2016.16.2.127
  23. Syrjanen J, Peltola J, Valtonen V, Iivanainen M, Kaste M, Huttunen JK: Dental infections in association with cerebral infarction in young and middle-aged men. J Intern Med 225: 179-184, 1989. https://doi.org/10.1111/j.1365-2796.1989.tb00060.x https://doi.org/10.1111/j.1365-2796.1989.tb00060.x
  24. Abnet CC, Qiao YL, Dawsey SM, Dong ZW, Taylor PR, Mark SD: Tooth loss is associated with increased risk of total death and death from upper gastrointestinal cancer, heart disease, and stroke in a Chinese population-based cohort. Int J Epidemiol 34: 467-474, 2005. https://doi.org/10.1093/ije/dyh375 https://doi.org/10.1093/ije/dyh375
  25. Wu T, Trevisan M, Genco RJ, Dorn JP, Falkner KL, Sempos CT: Periodontal disease and risk of cerebrovascular disease: the first national health and nutrition examination survey and its follow-up study. Arch Intern Med 160: 2749-2755, 2000. https://doi.org/10.1001/archinte.160.18.2749 https://doi.org/10.1001/archinte.160.18.2749
  26. Beck J, Garcia R, Heiss G, Vokonas PS, Offenbacher S: Periodontal disease and cardiovascular disease. J Periodontol 67(10 Suppl): 1123-1137, 1996. https://doi.org/10.1902/jop.1996.67.10s.1123 https://doi.org/10.1902/jop.1996.67.10s.1123
  27. Lafon A, Pereira B, Dufour T, et al.: Periodontal disease and stroke: a meta-analysis of cohort studies. Eur J Neurol 21: 1155-1161, e66-e67, 2014. https://doi.org/10.1111/ene.12415 https://doi.org/10.1111/ene.12415
  28. You Z, Cushman M, Jenny NS, Howard G; REGARDS: Tooth loss, systemic inflammation, and prevalent stroke among participants in the reasons for geographic and racial difference in stroke (REGARDS) study. Atherosclerosis 203: 615-619, 2009. https://doi.org/10.1016/j.atherosclerosis.2008.07.037 https://doi.org/10.1016/j.atherosclerosis.2008.07.037
  29. Nakano K, Hokamura K, Taniguchi N, et al.: The collagen-binding protein of Streptococcus mutans is involved in haemorrhagic stroke. Nat Commun 2: 485, 2011. https://doi.org/10.1038/ncomms1491 https://doi.org/10.1038/ncomms1491