Association of tooth loss with silent lacunar infarction

Objectives: Poor oral health may be associated with an increased risk of ischemic stroke. However, there is little known whether this is associated with the progression of silent lacunar infarction. The objective of this study was to assess the association between number of teeth remaining and silent lacunar infarction by using magnetic resonance imaging (MRI). Further, we assessed the association between lacunar infarction and panoramic radiography measure that is related to endothelial dysfunction. Methods: Eighty-four subjects (mean age +/- SD, 58.0 +/- 11.3 years), 44 men and 40 women, who visited our periodontology clinic and had no previous diagnosis of ischemic stroke participated in this study. The subjects had dental radiographies and periodontal examinations. They also had MRI of the brain. One experienced neurosurgeon and 1 physician independently determined the presence of lacunar infarction on MRI. Panoramic radiography measure was determined by 1 experienced oral radiologist. The information of subject's lifestyles such as smoking and the histories of diseases such as hypertension, hyperlipidemia and diabetes were obtained by clinical record or structured questionnaire. Results: Of 84 subjects, 49 (58.3%) had lacunar infarction. Sixteen had multiple (7 or more) lesions. Multiple linear regression analysis revealed the significant association of the number of lacunar infarction (0, 1 to 7, and 7<) with age (P<0.001), the histories of diabetes (P=0.009) and hypertension (P=0.014) (adjusted r square=0.32) but not with number of teeth remaining (P=0.63) and panoramic radiography measure (P=0.80). Logistic regression analysis with forward manner showed that only the age was significant determinant of the presence of silent lacunar infarction (P<0.001). Conclusions: Tooth loss may not be associated with the progression of silent lacunar infarction among the patients who visit periodontology clinic.