Abstract TP230: The Severity of Cerebral Small Vessel Disease is Associated With Tooth Loss but Not With Serum Titer to Periodontal Pathogens in Acute Stroke Patients

Abstract

Introduction: Oral health conditions, including periodontal disease has been considered as a risk factor for cerebral or cardiovascular disease. Cerebral small vessel disease (SVD) such as white matter lesions (WMLs) or cerebral microbleeds (CMBs) are also associated with the incidence of stroke. However, it is unclear how oral health conditions are associated with the severity of SVD. Hypothesis: The purpose of this study is to examine the associations of oral health conditions (serum titer of periodontal pathogens or tooth loss) with the severity of SVD (WMLs or CMBs) in acute stroke patients. Methods: Acute stroke patients were enrolled in two stroke centers. Serum antibody titers of periodontal pathogens (16 pathogens) were evaluated within 3 days after stroke onset. The severity of WMLs was assessed by Fazekas classification; grade 0 and 1 were defined as mild and grade 2 and 3 as severe WMLs. The presence or numbers of CMBs was assessed by T2*-weighted MRI. The patients were evaluated for the numbers of tooth loss by a dentist in single center (Hiroshima university hospital). The severity of tooth loss was classified by the number 0 to 5 as mild and 6 or more as severe. Results: In total, 664 acute stroke patients were enrolled (ischemic, n=558 and hemorrhagic, n=106). No significant associations were detected between the grades of any serum antibody titers of periodontal pathogens and the severity of WMLs or CMBs. Of these, 124 patients were evaluated for the numbers of lost teeth. The patients with severe WMLs had severe tooth lost frequently compared to those with mild WMLs (70.7% vs. 39.4%, P=0.020). The patients with multiple CMBs (more than 2) had severe tooth lost frequently compared to those without (67.6% vs. 48.8%, P=0.048). After adjusting for age, sex, hypertension, diabetes, dyslipidemia and atrial fibrillation, severe tooth loss (odds ratio [OR] 2.82, 95% CI 1.23-6.47, P=0.014) were associated with the severity of WMLs. Similarly, severe tooth loss was also associated with the multiple CMBs after adjusting for those factors (OR 2.73, 95% CI 1.05-7.11, P=0.040). Conclusion: No association is detected between any serum antibody titer to periodontal pathogens and the severity of SVD. On the other hand, the severe tooth loss is associated with the severity of SVD.