Abstract Details

Title Dental Caries Associated with Incident Ischemic Stroke: Atherosclerosis Risk In Communities Study

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S22 - Cerebrovascular Disease and Interventional Neurology: Biomarkers, Mechanisms of Axonal Injury, Stroke, and Infection (2:40 PM-2:48 PM)

Poster/Presentation
Number 005

Background Periodontal disease (PD) is an independent risk factor for ischemic stroke. Dental Caries is an infection of the teeth, characterized by de-mineralization and destruction of the teeth that is pathophysiologically distinct from PD. Limited data is available linking dental caries with ischemic stroke.

Objective

We assessed the hypothesis that dental caries is associated with ischemic stroke and specific ischemic stroke subtypes in the Atherosclerosis Risk In Communities (ARIC) study.

Design/Methods Full-mouth clinical examination was performed to assess presence of dental caries in 6326 subjects from the dental cohort of the ARIC study without prior stroke. Additional risk factors such as age, gender, race, smoking status, diabetes, socioeconomic status, and PD status. All stroke diagnoses were based on computer-derived diagnosis and physician medical record review, with differences adjudicated by a second physician reviewer. Strokes were further classified according to etiologic subtype as thrombotic, lacunar and cardioembolic stroke.

Results At the fourth ARIC study visit, 18% (1146) of the 6326 participants had evidence of coronal dental caries. A total of 393 ischemic strokes occurred from 1996-98 to 2016, of which 52% (153) were thrombotic, 20% (80) were cardioembolic, and 17% (67) were lacunar stroke. Participants with ≥1 coronal dental caries (HR 1.9 95% CI 1.5-2.4) had an increased risk of incident ischemic stroke, compared with participants without dental caries. The association remained significant (HR 1.4 95% CI 1.1-1.8) after adjustment for Age, Race, Gender, BMI, Diabetes, Smoking status, education (3-levels) and presence of PD. There remained an independent association (HR 2.2 95% CI 1.3-3.6) with cardioembolic, but not with thrombotic or lacunar stroke.

Conclusions Results from this prospective cohort demonstrate an independent association between dental caries and ischemic stroke. The association was independent of PD. Further, we report a stronger and independent association with the cardioembolic stroke subtype.

Authors/Disclosures
Souvik Sen, MD, MS (USC Neurology) PRESENTER	Dr. Sen has nothing to disclose.
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Rebecca F. Gottesman, MD (Johns Hopkins University)	Dr. Gottesman has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Academy of Neurology. The institution of Dr. Gottesman has received research support from NIH.
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