To Study The Effect Of Oral Hygiene Situation On Stroke And The Relationship Between Oral Hygiene Situation And Carotid Plaque

Objective:The main pathology of cardio cerebrovascular disease are atherosclerosis and plaque rupture.Microbial infections( such as periodontal pathogen, helicobacter pylori, chlamydia pneumoniae infection) plays an important role in the initial,occurrence and development of atherosclerosis.The aim of this study was to explore the effect of oral hygiene on stroke and the relationship between oral hygiene and carotid artery lesions through oral health survey on inpatients and outpatients, in order to provide evidence for the prevention of cardio cerebrovascular disease.Methods:We studied 125 stroke patients of neurology in Taiyuan central hospital as case group from May 2015 to December 2015. We studied 163 non-stroke patients as control group measured carotid artery by ultrasonography in ultrasound department of the first hospital of Shanxi Medical University at the same time. Age, gender, height,weight,smoking history and medical history including hypertention, diabetes, hyperlipidemia were evaluated. Oral hygiene status were recorded and diffient causes of tooth loss was also calculated. The carotid plaque were assessed by using ultrasonography.Result:1.Analyses between case(stroke patients) and control(non-stroke patients) group1.1 General situation analysis:Case group age(65.70±11.34 years)was bigger than control group(61.76±15.10 years)(P<0.05).In addition, the pencentage of smoking history, hypertension, hyperlipidemia and carotid plaque in case group were higher than control group, and there were statistically significant(P<0.05).1.2 Oral situation analysis:Compara with control group,case group have more tooth loss because of periodontitis, less brushing frequency, more dental plaque index and less supragingival scaling,and there were statistically significant(P<0.05).1.3.The risk factors of stroke:On multivariate logistic analysis, the risk of stroke was higher on hypertension(OR=2.538,95%CI:1.432-4.499) and hyperlipidemia(OR=2.711,95%CI:1.536-4.785) patients,whose were 2.711,2.538 times more likely to have stroke. Tooth loss because of periodontitis(OR=1.038,95%CI:1.007-1.071),dental plaque index(OR=1.769,95%CI : 1.243-2.517) were the risk factor of stoke, on the contrary, supragingival scaling(OR=0.218,95%CI:0.103-0.460)was protective factor(P<0.05).2.According to carotid ultrasound examination results, we divided control group into plaque group(91 cases) and non-plaque group(72 cases).2.1General situation analysis:Plaque group age(65.70±11.34 years) was bigger than non-plaque group(61.76±15.10 years)(P<0.05).In addition,the pencentage of male, smoking history,hypertension, hyperlipidemia in plaque group were higher than non-plaque group, and there were statistically significant(P<0.05).2.2Oral situation analysis:Compara with non-plaque group, plaque group have more tooth loss because of periodontitis and more dental plaque index,and there were statistically significant(P <0.05).2.3The relationship analyse of carotid plaque:On multivariate logistic analysis, male(OR=3.780,95%CI:1.785-8.007), age(OR=1.048, 95% CI:1.018-1.079), hypertension(OR=2.251,95%CI:1.052-4.814),hyperlipidemia(OR=2.277, 95%CI : 1.060-4.893),tooth loss because of periodontitis(OR=1.065,95%CI:1.001-1.133)were positive associated with the carotid artery lesions(P<0.05).Conclusion:1.Hypertension and hyperlipidemia history, the increased tooth loss due to periodontitis and increased dental calculus,whose may be risk factors,may increase the risk of stroke;but supragingival scaling may reduce the risk of stroke,and it may be protective factor.2.Age increased, male, hypertension and hyperlipidemia history, tooth loss increased because of periodontitis associated with caritid plaque formation. Thus we speculate that may be a risk factor for atherosclerosis.