According to a recent study, how we take care of our oral hygiene could be linked to a heightened risk of stroke.
The study titled ‘Relationship Between Periodontitis and Atrial Fibrosis in Atrial Fibrillation: Histological Evaluation of Left Atrial Appendages’ shows how a gum disease is tied to one of the most common causes of stroke.
Atrial fibrosis is known for contributing to the onset and persistence of atrial fibrillation (AF) and AF-related stroke.
Meanwhile, periodontitis, which is a common infection and inflammatory disease, is known to aggravate some systemic diseases.
Study first author, Shunsuke Miyauchi says: “Periodontitis is associated with a long-standing inflammation, and inflammation plays a key role in atrial fibrosis progression and atrial fibrillation pathogenesis.”
Previous to this study, the relationship between periodontitis and AF had remained unknown.
The main objective of the study’s authors was to elucidate the relationship between periodontitis and atrial fibrosis, by studying resected left atrial appendages (LAAs).
Study method
For this study, 76 patients with AF (55 with nonparoxysmal AF, 25 with mitral valve regurgitation, 18 with LAA thrombus) who were due to undergo LAA excision during cardiac surgery were prospectively enrolled.
All patients had an oral examination, with researchers examining the remaining number of teeth, bleeding on probing, periodontal probing depth, and periodontal inflamed surface area (PISA) were all evaluated as parameters of periodontitis.
The degree of fibrosis in each LAA was quantified by Azan-Mallory staining.
Study Results
Bleeding on probing (R = 0.48; P < 0.0001), periodontal probing depth of ≥4 mm (R = 0.26; P = 0.02), and PISA (R = 0.46; P < 0.0001) were positively correlated with atrial fibrosis.
Amongst patients with less than 10 remaining teeth, PISA was positively and strongly correlated with atrial fibrosis (R = 0.57; P < 0.0001).
After adjustments were made for age, AF duration, BMI, mitral valve regurgitation, and CHADS₂ (congestive heart failure, hypertension, age, diabetes, previous stroke/transient ischemic attack) score, PISA was significantly linked to atrial fibrosis (β = 0.016; P = 0.0002).
“This study provides basic evidence that periodontitis can aggravate atrial fibrosis and can be a novel modifiable risk factor for atrial fibrillation,” says corresponding author Yukiko Nakano.
Study conclusions
The study authors have displayed the association of periodontitis with atrial fibrosis, which thus indicates that periodontitis, which is modifiable, is a likely a risk factor for AF.
Nakano says: “Further evidence is required for establishing that periodontitis contributes to the atrial fibrosis in a causal manner and that periodontal care can alter fibrosis.
“One of our goals is to confirm that periodontitis is a modifiable risk factor for atrial fibrillation and to promote dental specialists’ participation in comprehensive atrial fibrillation management. Periodontitis is an easy modifiable target with lower cost among known atrial fibrillation risk factors. Thus, the achievement of this study series may bring benefits for many people worldwide.”
