The Surprising Stroke Risk that Affects 50% of Americans Over Age 30

Can you still have a stroke if you exercise everyday, eat clean, and get regular check-ups? Yes, indeed you can. We all know of celebrities and local friends, acquaintances, even loved ones who have had a stroke, despite being “the healthiest person” we know.

What happens? And how can you, “healthy” or not, look on the inside of your body and see if you are headed for a stroke? Of my top 7 MUST-HAVE tests for stroke prevention, 2 are often missing from your annual check-up, or even a prevention-focused work-up. One test is the saliva test to see if you have a bacterial infection in your mouth. You can have these dangerous bacteria without symptoms. And, why does it matter?

Approximately 50% of Americans over age 30 (about 65 million people) have periodontal disease (PD) which involves the presence of these dangerous bacteria. Also known as gum disease, PD is a chronic infection of the gums, connective tissue and bones supporting the teeth that can double or even triple risk for stroke or a heart attack. Symptoms may include red, swollen, tender gums; bleeding while brushing or flossing; receding gums; loose or sensitive teeth; and persistent bad breath. But you can harbor dangerous bacteria in your mouth – without any symptoms? Very often, PD has no symptoms in the early stages. As a result, millions of people don’t realize they have a serious oral infection that can lead to tooth loss, bone loss, stroke and heart attack.

A landmark, peer-reviewed study published in Postgraduate Medical Journal (PMJ) was the first to identify PD due to certain high-risk bacteria as a contributing cause of atherosclerosis. These germs, which often enter the bloodstream and spread throughout the body, gang up to create a triple threat to arterial health that can lead to heart attacks and strokes:

People with gum disease have twice as much small, dense LDL cholesterol (the most dangerous kind) in their blood as those with healthy gums.
Chemicals produced by high-risk oral bacteria make it easier for bad cholesterol to invade artery walls.

These chemicals make the inner layers of the artery wall (where plaque forms) stickier, like Velcro, so that cholesterol is more likely to get trapped there and clump into plaque.
Healthy Gums Help Prevent Strokes and Heart Attacks!

Poor oral health has also been linked to many other serious health threats, including diabetes, chronic kidney disease, some forms of cancer and dementia. Here’s more motivation to get a dental checkup: In a study of nearly 6,000 people ages 50 and older, those who hadn’t seen a dentist in the previous year had a 50% higher death rate than those who went two or more times annually! The researchers also reported that those who brushed and flossed daily lived longer than people the same age with neither of these habits, even when other risk factors were taken into account.

The PMJ study is changing how dental providers diagnose and manage gum disease, since it’s important to find out if people with PD have the high-risk bacteria now known to be a contributing cause of arterial disease. Instead of only evaluating the severity of a patient’s symptoms — such as how deep the pockets of infection are, how much the gums bleed, or how loose the teeth are dentists and dental hygienists are now using saliva testing to measure oral pathogens through DNA analysis.

Finding out if PD is due to high-risk bacteria is important to protect your oral-systemic health. What does that mean? Through research, we are understanding more and. more about the significant connection between oral health and the health of your body “system” as a whole.

Treatments for PD include nonsurgical periodontal therapy, a daily program of oral care to follow at home, prescription mouthwashes, dental trays with antibacterial gel (PerioProtect) and, in some cases, a short course of antibiotics. Regardless of which treatment is prescribed, I recommend repeating the oral saliva test to make sure the treatment was successful.

As we recently reported, heart attacks and strokes are on the rise among young adults (those under age 55), particularly among women. In June, The Wall Street Journal reported that after decades of decreases in death rates for arterial disease, fatalities among people ages 45 to 54 are now going up. In fact, middle-aged Americans are more likely to die of arterial disease now than they were in 2011!

Working closely with both your medical and dental providers to identify and treat all of your cardiovascular risks — including gum disease — could save your life. In a recent study of 10,000 initially stroke-free people, published in the journal Stroke, those with PD were more than twice as likely to suffer heart attacks and strokes than those with healthy gums. However, getting regular dental care significantly reduced risk for both types of events.