title: Gingival Inflammation Associates with Stroke--A Role for Oral Health Personnel in Prevention: A Database Study.
abstract: OBJECTIVE
  Gingival inflammation is the physiological response to poor oral hygiene. If gingivitis is not resolved the response will become an established lesion.We studied whether gingivitis associates with elevated risk for stroke. The hypothesis was based on the periodontitis-atherosclerosis paradigm.
  
  
  METHODS
  In our prospective cohort study from Sweden 1676 randomly selected subjects were followed up from 1985 to 2012. All subjects underwent clinical oral examination and answered a questionnaire assessing background variables such as socio-economic status and pack-years of smoking. Cases with stroke were recorded from the Center of Epidemiology, Swedish National Board of Health and Welfare, Sweden, and classified according to the WHO International Classification of Diseases. Unpaired t-test, chi-square tests, and multiple logistic regression analyses were used.
  
  
  RESULTS
  Of the 1676 participants, 39 subjects (2.3%) had been diagnosed with stroke. There were significant differences between the patients with stroke and subjects without in pack-years of smoking (p = 0.01), prevalence of gingival inflammation (GI) (p = 0.03), and dental calculus (p = 0.017). In a multiple regression analysis the association between GI, confounders and stroke, GI showed odds ratio 2.20 (95% confidence interval 1.02-4.74) for stroke.
  
  
  CONCLUSIONS
  Our present findings showed that gingival inflammation clearly associated with stroke in this 26-year cohort study. The results emphasize the role of oral health personnel in prevention.
authors.affiliation: Department of Dental Medicine, Karolinska Institutet, Box 4064, 141 04 Huddinge, Sweden.
authors.forename: Birgitta
authors.initials: B
authors.lastname: Söder
authors.affiliation: Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, PB 41, FI-00014 Helsinki, Finland.
authors.forename: Jukka H
authors.initials: JH
authors.lastname: Meurman
authors.affiliation: Department of Dental Medicine, Karolinska Institutet, Box 4064, 141 04 Huddinge, Sweden.
authors.forename: Per-Östen
authors.initials: PÖ
authors.lastname: Söder
mesh_terms: D050197:Atherosclerosis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D016208:Databases, Factual; D005260:Female; D005891:Gingivitis / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene; D010518:Periodontitis / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D011446:Prospective Studies; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D013548:Sweden