Gum disease may be associated with cerebral small vessel disease (CSVD), a leading cause of stroke, in patients with ischemic stroke, according to a new study published on December 5 in the Journal of Stroke and Cerebrovascular Diseases.
The rates of Fusobacterium nucleatum, a germ that commonly causes gum disease, in the oral cavity were significantly associated with CSVD in patients with stroke, the authors wrote.
"Oral care targeting F. nucleatum may aid in impeding CSVD progression," wrote the authors, led by Dr. Hiromi Nishi, PhD, of Hiroshima University Hospital in Japan.
An increased risk of stroke is correlated with periodontitis. Recent studies suggest that gum disease aggravates CSVD, including lacunar stroke. CSVD causes about 20% of strokes globally. However, which gum disease germs are linked to CSVD are not clear.
To explore the relationship between the relative rates of periodontal germs in the oral cavity and CSVD, rates of periodontal pathogens on the tongue's coating, background factors, and CSVD imaging were analyzed in 347 patients with acute ischemic stroke. The rate of gum disease germs was measured using quantitative polymerase chain reaction for six species of periodontal pathogens. Positivity for each germ was defined as the presence of more than one-third quartile of the amount of each periodontal pathogen relative to the total amount of bacteria on their tongues, according to the study.
F. nucleatum was independently linked to high-grade white-matter hyperintensities (odds ratio [OR], 1.84; 95% confidence interval [CI], 1.10-3.08; p = 0.021) and high-grade total CSVD score (OR, 1.76; 95% CI, 1.04-2.96; p = 0.035), the authors wrote.
Nevertheless, the study had limitations, including conditions such as tooth loss, periodontal disease grade, socioeconomic status, and access to dental care were not evaluated. Therefore, it couldn't be eliminated that these conditions affect CSVD in stroke patients, they wrote.
"In conclusion, we demonstrated that the qualitative positivity for F. nucleatum in the oral cavity was independently associated with high-grade white matter hyperintensities and high-grade total CSVD score in patients with ischemic stroke," Nishi and colleagues wrote.
