The relationship between dental disease and cerebral vascular accident in elderly United States veterans.
We report here information obtained from a cross-sectional study of 401 veterans, who were at least 60 years of age, which showed that several dental/oral conditions can be significantly associated with the diagnosis of a cerebral vascular accident (CVA), when included in a multivariate logistic regression model with and without many of the known risk factors for a CVA. The dental findings relative to the prevalence of dental caries and periodontal disease were not distinctly different between the subjects with and without a CVA in the bivariate analysis. A higher stimulated salivary flow was negatively associated with a CVA in the multivariate models. The plaque index and oral hygiene habits relating to brushing, flossing, and frequency of having teeth cleaned by a dentist/hygienist were significantly associated with a CVA in the bivariate analysis. Among these oral hygiene parameters, *needing help in brushing one's teeth" and the reported annual visit to the dentist/hygienist for teeth cleaning remained significant in the multivariate models involving the dependent-living subjects. The need for help in brushing one's teeth could reflect the fact that many subjects had reduced manual dexterity as a result of the CVA and required this extra care. However, the finding that those dependent-living individuals who reported that they did not have their teeth cleaned at least once a year were 4.76 times more likely to have had a CVA, suggests that a pattern of oral neglect might be associated with developing a CVA. The implications of this in terms of an intervention strategy for CVA warrants further consideration. However, caution is recommended because the data were obtained from a convenience sampling of older veterans and may not be generalizable to other populations.
University of Michigan, School of Dentistry, Department of Biologic and Materials Science, Ann Arbor, MI, USA. WLoesche@umich.edu
W J
WJ
Loesche
A
A
Schork
M S
MS
Terpenning
Y M
YM
Chen
C
C
Kerr
B L
BL
Dominguez
D000368:Aged; D000428:Alcohol Drinking; D002561:Cerebrovascular Disorders / Q000453:epidemiology / Q000209:etiology*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004245:DMF Index; D016321:Dental Care for Aged / Q000706:statistics & numerical data*; D003774:Dental Plaque Index; D005260:Female; D006801:Humans; D016015:Logistic Models; D008134:Long-Term Care; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D009910:Oral Hygiene / Q000706:statistics & numerical data*; D010510:Periodontal Diseases / Q000150:complications*; D010512:Periodontal Index; D012907:Smoking; D018709:Statistics, Nonparametric; D016388:Tooth Loss / Q000150:complications; D014728:Veterans / Q000706:statistics & numerical data; D014987:Xerostomia / Q000150:complications