Having a stroke is something that is terrifying in theory, yet may feel a long ways off if you are under a certain age. The fact, though, is that it isn’t just the elderly that are susceptible to the potentially life-threatening dangers of strokes.

Similarly, gum disease isn’t something that many people — of any age — seem to spend much time worrying about. Because of its relatively mild symptoms and lack of pain, people tend to shrug off the diagnosis as unimportant. However, untreated gum disease can lead to bleeding and sore gums, bad breath and even lost teeth. There is also evidence that the bacteria in gum disease may be related to other systemic health problems.

Research linking gum disease and strokes

In honor of National Stroke Awareness Month, we tackle the question: are gum disease and stroke related? Scientific evidence suggests so. In 2004, researchers in Germany identified an increased risk for an ischemic stroke for patients also suffering severe gum disease (also known as periodontitis), especially for men and patients under the age of 60. Ischemic strokes, which account for 85% of all strokes according to the CDC, happen when a blood vessel delivering blood to the brain is blocked, preventing oxygen from getting through, which can lead to permanent damage or even death.

Research has also confirmed an independent association between gum disease and cardioembolic and thrombotic stroke sub-types.  Thrombotic strokes happen when a blood clot develops in the blood vessels inside the brain.  Cardioembolic strokes are caused when the heart pumps debris or a blood clot into the brain.

There is a significant association between periodontal disease and atrial fibrillation. Atrial fibrillation (also called AFib or AF) is an irregular heartbeat, usually rapid and can lead to blood clots, stroke and heart failure. AF is the most common reason for cardioembolic strokes. The more severe the periodontal disease, the greater association with AF.  Research suggests that the links between AF and gum disease may help explain the cardioembolic stroke risk that is associated with gum disease.

What links gum disease and stroke?

Where does the connection lie? Scientists hypothesize that oral bacteria may be what makes gum disease and stroke related. Bacteria in the mouth enters the bloodstream through diseased gums, where it then becomes attached to fatty plaques in the bloodstream. These plaques directly contribute to crucial artery blockages. Additionally, the bacteria triggers an inflammatory response from the body causing the liver to produce and release High Sensitivity C-reactive protein (hsCRP).  HsCRP can be used to measure overall inflammation and is also a marker for cardiovascular disease (CVD). Blood vessels to swell and harden, reducing blood flow and increasing the risk of clots.

Research published in 2018 hypothesizes that reducing the bacteria causing periodontal disease will decrease the risks of CVD.

While more research needs to be done to fully understand how gum disease and stroke are related, scientists say the presence of gum disease and other common mouth issues (cavities, missing teeth, etc.) were just as good as cholesterol levels at predicting heart conditions, including those that lead to stroke.

Use the knowledge to keep up your health

The good news is, in addition to working on your diet and exercise routine, you can take another step to ensuring your heart and brain health by addressing your oral health. Maintaining consistent brushing and flossing routines and regular visits to a dental professional can help keep gum disease from becoming rampant. If you’ve already been diagnosed, you have a few options to get treated — including a minimally invasive laser treatment called the LANAP protocol — that will not only address your oral health but may also help the rest of your body.

Now that you are armed with knowledge of how gum disease and stroke are related, here are a few signs to look out for if you’re concerned you may be experiencing a stroke or advanced gum disease.

Stroke warning signs
  • Drooping facial expression on one side
  • Difficulty raising one arm
  • Slurring or other difficulty speaking
  • Sudden trouble with your eyesight
  • Dizziness and/or confusion
  • Severe headache with sudden onset

(via American Stroke Association)

Gum disease warning signs
  • Bleeding or swollen gums (even mild cases, aka “pink in the sink”)
  • Sensitive gums or teeth
  • Receding gums (appearance of longer teeth)
  • Bad breath
  • Loose teeth

See even more symptoms and facts about gum disease here.