On a day to day practice, dentist may encounter patients with various medical conditions such as Brain stroke, heart attack, deep vein thrombosis, pulmonary embolism. In these conditions blood clot formation seen in arteries and veins. Ischemic cerebral infarction or stroke preceded by systemic bacterial or viral infection. Poor dental health is a significant risk factor for cerebrovascular ischemia. Is there a Relation Between Brain Stroke And Oral Health?
In one study bleeding on probing, suppuration, subgingival calculus and number of periodontal or periapical lesions were more in male stroke patients than in controls (healthy patients). 25% of all brain stroke patients had significant dental infections than 2.5% of controls. Poor oral health is a risk factor for stroke. In another study patients with greater than 20% mean radiographic bone loss at base line were three times as likely to have a stroke than patients with less than 20% bone loss. Periodontitis is a greater risk factor for stroke than smoking. Hence Systematic reviews suggest that there, threefold increased risk of stroke in periodontitis.
Action Mechanism of Brain Stroke on Oral Health:
Brain Stroke caused by thromboembolic events. Periodontal pathogens and their products such as gram-negative bacteria lipopolysaccharide result in damage to vascular endothelium. In addition there is hyper responsive monocyte/macrophage phenotype enter vessel wall producing cytokines/growth factor that increase inflammatory response. This may lead to the formation of atheromatous lesion which proliferate in the vessel wall. Damaged endothelium can cause activation of platelets resulting in their aggregation. These actions lead to atheromatosis and narrowing of the vessel lumen.
Hence, Brain stroke patients often experience depression, anxiety, mood swings and extreme tiredness, which may result in failure of patients to keep their dental appointments, appreciate treatments or comply with oral hygiene instructions. Patients may also be confused and unable to recognise the use of everyday objects related to oral health care. Must tell your complete medical history to your dentist.
Furthermore, periodontal infection stimulates a series of indirect systemic effects such as elevated production of fibrinogen; CR, which serve to increase the risk of stroke. Bacteremia with PAAP positive bacterial strains from the supragingival and subgingival plaque increases platelet aggregation, contributing to thrombus formation and subsequent thromboembolism which is the leading cause of stroke.
Therefore, For many years dental profession has recognized the effects of systemic conditions on the oral cavity. Periodontal infection acts as independent risk factor for systemic disease. Also, periodontal infection may exacerbate existing systemic disorders. Yes , there is a direct relation between Relation Between Brain Stroke And Oral Health.
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