Role of common oral infectious diseases in inducing stroke: a review of research progress_West China Medical Journal

Authors：

YE Xin ^1,2 , HUANG Shuqi ² ,  LIU Fan ^1,2

1. West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Nursing, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIU Fan, Email: samotj@163.com

Keywords：

Stroke; oral infectious diseases; oral health

DOI：

10.7507/1002-0179.202307061

Video：

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As a major disease that seriously endangers the health of Chinese residents, stroke has various triggering factors, among which infection is one of the initial factors. Previous studies have indicated a correlation of common oral infectious diseases such as periodontitis with the occurrence of stroke. However, there is a lack of effective integration of previous research on the induction of stroke by common oral infectious diseases. This article provides a comprehensive review of the relevant research on infectious diseases and stroke, with a particular focus on the progress related to periodontitis, gingivitis, dental caries, and pulpitis as triggers for stroke. It puts forward relevant recommendations for promoting oral health, so as to provide a theoretical basis for improving oral health literacy of Chinese residents and reducing the incidence of stroke and other major diseases.

Citation： YE Xin, HUANG Shuqi, LIU Fan. Role of common oral infectious diseases in inducing stroke: a review of research progress. West China Medical Journal, 2023, 38(12): 1920-1923. doi: 10.7507/1002-0179.202307061 Copy

1.	Fan J, Li X, Yu X, et al. Global burden, risk factor analysis, and prediction study of ischemic stroke, 1990-2030. Neurology, 2023, 101(2): e137-e150.
2.	Murala S, Nagarajan E, Bollu PC. Infectious causes of stroke. J Stroke Cerebrovasc Dis, 2022, 31(4): 106274.
3.	《中国脑卒中防治报告》编写组. 《中国脑卒中防治报告 2020》概要. 中国脑血管病杂志, 2022, 19(2): 136-144.
4.	Kojo T, Ae R, Kosami K, et al. Prevention paradox between stroke and multiple potential risk factors using data from a population-based cohort study. Prev Med, 2021, 153: 106857.
5.	Mishra AK, Lal A, George AA. Letter by Mishra et al Regarding Article, “Infection as a Stroke Trigger: Associations Between Different Organ System Infection Admissions and Stroke Subtypes”. Stroke, 2019, 50(11): e328.
6.	李雨潇, 吴红崑. 口腔常见感染性疾病与老年人脑小血管病研究现状. 中华老年口腔医学杂志, 2020, 18(2): 119-123.
7.	Dewan M, Pandit AK, Goyal L. Association of periodontitis and gingivitis with stroke: a systematic review and meta-analysis. Dent Med Probl, 2023.
8.	Bell S, Gibson JT, Harshfield EL, et al. Is periodontitis a risk factor for ischaemic stroke, coronary artery disease and subclinical atherosclerosis? A Mendelian randomization study. Atherosclerosis, 2020, 313: 111-117.
9.	翟浩嫣, 赵圆, 范登莹, 等. 活性氧影响牙周炎发生发展及牙周组织再生. 中国组织工程研究, 2024, 28(14): 2254-2260.
10.	Chen MX, Zhong YJ, Dong QQ, et al. Global, regional, and national burden of severe periodontitis, 1990-2019: an analysis of the Global Burden of Disease Study 2019. J Clin Periodontol, 2021, 48(9): 1165-1188.
11.	Kassebaum NJ, Bernabé E, Dahiya M, et al. Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression. J Dent Res, 2014, 93(11): 1045-1053.
12.	王兴. 第四次全国口腔流行病学调查报告. 北京: 人民卫生出版社, 2018: 11-144.
13.	Sanz M, Del Castillo AM, Jepsen S, et al. Periodontitis and cardiovascular diseases. Consensus report. Glob Heart, 2020, 15(1): 1.
14.	朱慈燕, 韩辉. 口腔疾病与脑血管病的关系. 临床与病理杂志, 2020, 40(12): 3313-3316.
15.	Armitage GC. Periodontal infections and cardiovascular disease--how strong is the association?. Oral Dis, 2000, 6(6): 335-350.
16.	Dietrich T, Sharma P, Walter C, et al. The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease. J Periodontol, 2013, 84(4 Suppl): S70-S84.
17.	Nazir MA. Prevalence of periodontal disease, its association with systemic diseases and prevention. Int J Health Sci (Qassim), 2017, 11(2): 72-80.
18.	Sen S, Giamberardino LD, Moss K, et al. Periodontal disease, regular dental care use, and incident ischemic stroke. Stroke, 2018, 49(2): 355-362.
19.	Lin HW, Chen CM, Yeh YC, et al. Dental treatment procedures for periodontal disease and the subsequent risk of ischaemic stroke: a retrospective population-based cohort study. J Clin Periodontol, 2019, 46(6): 642-649.
20.	余晓波. 牙周病患者口腔保健知识及保健行为调查分析. 九江学院学报(自然科学版), 2017, 32(2): 106-108.
21.	Kumar S. Evidence-based update on diagnosis and management of gingivitis and periodontitis. Dent Clin North Am, 2019, 63(1): 69-81.
22.	Söder B, Meurman JH, Söder PÖ. Gingival inflammation associates with stroke--a role for oral health personnel in prevention: a database study. PLoS One, 2015, 10(9): e0137142.
23.	张军梅, 赵春霞, 王秉文, 等. 部分口腔疾病与脑卒中高危人群的相关性. 牙体牙髓牙周病学杂志, 2015, 25(2): 104-106.
24.	纪悦. 牙周健康状况与腔隙性脑梗死相关性初探. 沈阳: 中国医科大学, 2009.
25.	Lafon A, Pereira B, Dufour T, et al. Periodontal disease and stroke: a meta-analysis of cohort studies. Eur J Neurol, 2014, 21(9): 1155-1161, e66-e67.
26.	Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 2012, 380(9859): 2163-2196.
27.	宋洁, 吴泽钰, 赵今. 早期龋病局部使用药物的研究进展. 重庆医学, 2022, 51(20): 3578-3582.
28.	Frencken J. Caries epidemiology and its challenges. Monogr Oral Sci, 2018, 27: 11-23.
29.	马少丛. 脑血管疾病患者的口腔情况调查. 石家庄: 河北医科大学, 2021.
30.	Dai R, Lam OL, Lo EC, et al. A systematic review and meta-analysis of clinical, microbiological, and behavioural aspects of oral health among patients with stroke. J Dent, 2015, 43(2): 171-180.
31.	Inenaga C, Hokamura K, Nakano K, et al. A potential new risk factor for stroke: Streptococcus mutans with collagen-binding protein. World Neurosurg, 2018, 113: e77-e81.
32.	中华人民共和国中央人民政府. 中共中央国务院印发《“健康中国 2030”规划纲要》. 中华人民共和国国务院公报, 2016(32): 5-20.
33.	中华人民共和国中央人民政府. 国务院办公厅关于印发中国防治慢性病中长期规划(2017—2025 年)的通知. 中华人民共和国国务院公报, 2017(7): 17-24.
34.	杜嘉琪, 王翔宇, 李俊明, 等. 山西省居民含氟牙膏防龋功效认知和使用情况调查. 预防医学, 2020, 32(7): 733-735.
35.	Tampi MP, Pilcher L, Urquhart O, et al. Antibiotics for the urgent management of symptomatic irreversible pulpitis, symptomatic apical periodontitis, and localized acute apical abscess: systematic review and meta-analysis-a report of the American Dental Association. J Am Dent Assoc, 2019, 150(12): e179-e216.
36.	Cowan LT, Lakshminarayan K, Lutsey PL, et al. Endodontic therapy and incident cardiovascular disease: the Atherosclerosis Risk in Communities (ARIC) study. J Public Health Dent, 2020, 80(1): 79-91.
37.	Lin PY, Chien KL, Chang HJ, et al. Unfinished root canal treatments and the risk of cardiovascular disease. J Endod, 2015, 41(12): 1991-1996.
38.	徐心怡, 吕岩, 郭斌, 等. 老年人根管治疗依从性的相关因素分析. 中华老年口腔医学杂志, 2013, 11(2): 89-94.

1. Fan J, Li X, Yu X, et al. Global burden, risk factor analysis, and prediction study of ischemic stroke, 1990-2030. Neurology, 2023, 101(2): e137-e150.
2. Murala S, Nagarajan E, Bollu PC. Infectious causes of stroke. J Stroke Cerebrovasc Dis, 2022, 31(4): 106274.
3. 《中国脑卒中防治报告》编写组. 《中国脑卒中防治报告 2020》概要. 中国脑血管病杂志, 2022, 19(2): 136-144.
4. Kojo T, Ae R, Kosami K, et al. Prevention paradox between stroke and multiple potential risk factors using data from a population-based cohort study. Prev Med, 2021, 153: 106857.
5. Mishra AK, Lal A, George AA. Letter by Mishra et al Regarding Article, “Infection as a Stroke Trigger: Associations Between Different Organ System Infection Admissions and Stroke Subtypes”. Stroke, 2019, 50(11): e328.
6. 李雨潇, 吴红崑. 口腔常见感染性疾病与老年人脑小血管病研究现状. 中华老年口腔医学杂志, 2020, 18(2): 119-123.
7. Dewan M, Pandit AK, Goyal L. Association of periodontitis and gingivitis with stroke: a systematic review and meta-analysis. Dent Med Probl, 2023.
8. Bell S, Gibson JT, Harshfield EL, et al. Is periodontitis a risk factor for ischaemic stroke, coronary artery disease and subclinical atherosclerosis? A Mendelian randomization study. Atherosclerosis, 2020, 313: 111-117.
9. 翟浩嫣, 赵圆, 范登莹, 等. 活性氧影响牙周炎发生发展及牙周组织再生. 中国组织工程研究, 2024, 28(14): 2254-2260.
10. Chen MX, Zhong YJ, Dong QQ, et al. Global, regional, and national burden of severe periodontitis, 1990-2019: an analysis of the Global Burden of Disease Study 2019. J Clin Periodontol, 2021, 48(9): 1165-1188.
11. Kassebaum NJ, Bernabé E, Dahiya M, et al. Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression. J Dent Res, 2014, 93(11): 1045-1053.
12. 王兴. 第四次全国口腔流行病学调查报告. 北京: 人民卫生出版社, 2018: 11-144.
13. Sanz M, Del Castillo AM, Jepsen S, et al. Periodontitis and cardiovascular diseases. Consensus report. Glob Heart, 2020, 15(1): 1.
14. 朱慈燕, 韩辉. 口腔疾病与脑血管病的关系. 临床与病理杂志, 2020, 40(12): 3313-3316.
15. Armitage GC. Periodontal infections and cardiovascular disease--how strong is the association?. Oral Dis, 2000, 6(6): 335-350.
16. Dietrich T, Sharma P, Walter C, et al. The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease. J Periodontol, 2013, 84(4 Suppl): S70-S84.
17. Nazir MA. Prevalence of periodontal disease, its association with systemic diseases and prevention. Int J Health Sci (Qassim), 2017, 11(2): 72-80.
18. Sen S, Giamberardino LD, Moss K, et al. Periodontal disease, regular dental care use, and incident ischemic stroke. Stroke, 2018, 49(2): 355-362.
19. Lin HW, Chen CM, Yeh YC, et al. Dental treatment procedures for periodontal disease and the subsequent risk of ischaemic stroke: a retrospective population-based cohort study. J Clin Periodontol, 2019, 46(6): 642-649.
20. 余晓波. 牙周病患者口腔保健知识及保健行为调查分析. 九江学院学报(自然科学版), 2017, 32(2): 106-108.
21. Kumar S. Evidence-based update on diagnosis and management of gingivitis and periodontitis. Dent Clin North Am, 2019, 63(1): 69-81.
22. Söder B, Meurman JH, Söder PÖ. Gingival inflammation associates with stroke--a role for oral health personnel in prevention: a database study. PLoS One, 2015, 10(9): e0137142.
23. 张军梅, 赵春霞, 王秉文, 等. 部分口腔疾病与脑卒中高危人群的相关性. 牙体牙髓牙周病学杂志, 2015, 25(2): 104-106.
24. 纪悦. 牙周健康状况与腔隙性脑梗死相关性初探. 沈阳: 中国医科大学, 2009.
25. Lafon A, Pereira B, Dufour T, et al. Periodontal disease and stroke: a meta-analysis of cohort studies. Eur J Neurol, 2014, 21(9): 1155-1161, e66-e67.
26. Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 2012, 380(9859): 2163-2196.
27. 宋洁, 吴泽钰, 赵今. 早期龋病局部使用药物的研究进展. 重庆医学, 2022, 51(20): 3578-3582.
28. Frencken J. Caries epidemiology and its challenges. Monogr Oral Sci, 2018, 27: 11-23.
29. 马少丛. 脑血管疾病患者的口腔情况调查. 石家庄: 河北医科大学, 2021.
30. Dai R, Lam OL, Lo EC, et al. A systematic review and meta-analysis of clinical, microbiological, and behavioural aspects of oral health among patients with stroke. J Dent, 2015, 43(2): 171-180.
31. Inenaga C, Hokamura K, Nakano K, et al. A potential new risk factor for stroke: Streptococcus mutans with collagen-binding protein. World Neurosurg, 2018, 113: e77-e81.
32. 中华人民共和国中央人民政府. 中共中央国务院印发《“健康中国 2030”规划纲要》. 中华人民共和国国务院公报, 2016(32): 5-20.
33. 中华人民共和国中央人民政府. 国务院办公厅关于印发中国防治慢性病中长期规划(2017—2025 年)的通知. 中华人民共和国国务院公报, 2017(7): 17-24.
34. 杜嘉琪, 王翔宇, 李俊明, 等. 山西省居民含氟牙膏防龋功效认知和使用情况调查. 预防医学, 2020, 32(7): 733-735.
35. Tampi MP, Pilcher L, Urquhart O, et al. Antibiotics for the urgent management of symptomatic irreversible pulpitis, symptomatic apical periodontitis, and localized acute apical abscess: systematic review and meta-analysis-a report of the American Dental Association. J Am Dent Assoc, 2019, 150(12): e179-e216.
36. Cowan LT, Lakshminarayan K, Lutsey PL, et al. Endodontic therapy and incident cardiovascular disease: the Atherosclerosis Risk in Communities (ARIC) study. J Public Health Dent, 2020, 80(1): 79-91.
37. Lin PY, Chien KL, Chang HJ, et al. Unfinished root canal treatments and the risk of cardiovascular disease. J Endod, 2015, 41(12): 1991-1996.
38. 徐心怡, 吕岩, 郭斌, 等. 老年人根管治疗依从性的相关因素分析. 中华老年口腔医学杂志, 2013, 11(2): 89-94.

West China Medical Journal

Role of common oral infectious diseases in inducing stroke: a review of research progress

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