Department of Neurology, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
J Periodontol. 2021 Jan;92(1):87-94. doi: 10.1002/JPER.20-0053. Epub 2020 Jun 12.
Periodontal disease or poor oral hygiene may lead to local infection, inflammation, and systemic inflammatory reactions, which are important mediators of development of stroke. We aimed to investigate the association of oral hygiene with risk of stroke in a nationwide population-based cohort.
From Korean National Health Insurance System-Health Screening Cohort, 206,602 participants without missing data regarding demographic information, medical history, or blood/urine examination results were included. The presence of periodontal disease and indicators of oral hygiene, such as number of tooth brushings, dental visit history, dental scaling, and number of teeth loss and dental caries were evaluated. Occurrence of stroke including cerebral infarction, cerebral hemorrhage, and subarachnoid hemorrhage was defined as newly registration of International Classification of Diseases-10 codes from I60 to I64 accompanying brain CT and/or MR examination at that time of diagnosis.
The 7337 (3.6%) cases of stroke including 5795 (79.0%) cases of cerebral infarction, 1568 (21.4%) cases of cerebral hemorrhage, and 621 (8.5%) cases of subarachnoid hemorrhage occurred during a median 10.4 years follow-up. In multivariable analysis, frequent tooth brushing (≥3 times per day) was negatively associated with risk of stroke occurrence (hazard ratio [HR]: 0.78, 95% confidence interval [CI]: 0.73-0.84). Number of dental caries (≥4) was positively related to stroke occurrence (HR: 1.28, 95% CI: 1.13-1.44).
Regular oral hygiene behavior was negatively, and infrequent oral hygiene care was positively associated with risk of occurrence for stroke, respectively. Brushing one's teeth three or more times daily may be associated with lower risk of stroke.
牙周病或口腔卫生不良可能导致局部感染、炎症和全身炎症反应，这些是中风发展的重要介导因素。我们旨在调查全国人群队列中口腔卫生与中风风险的关系。
从韩国国家健康保险系统-健康筛查队列中，纳入了 206602 名无缺失数据的参与者，包括人口统计学信息、病史或血液/尿液检查结果。评估了牙周病的存在以及口腔卫生的指标，如刷牙次数、牙科就诊史、洁牙、牙齿缺失和龋齿的数量。中风的发生包括脑梗死、脑出血和蛛网膜下腔出血，定义为国际疾病分类-10 代码（I60 至 I64）的新登记，伴有当时诊断时的脑部 CT 和/或 MRI 检查。
在中位 10.4 年的随访期间，共发生了 7337 例（3.6%）中风，包括 5795 例（79.0%）脑梗死、1568 例（21.4%）脑出血和 621 例（8.5%）蛛网膜下腔出血。多变量分析显示，频繁刷牙（≥3 次/天）与中风发生风险呈负相关（风险比[HR]：0.78，95%置信区间[CI]：0.73-0.84）。龋齿数量（≥4）与中风发生呈正相关（HR：1.28，95% CI：1.13-1.44）。
定期口腔卫生行为与中风发生风险呈负相关，而不频繁的口腔卫生护理则呈正相关。每天刷牙 3 次或以上可能与中风风险降低有关。
