Dental Caries Associated with Incident Ischemic Stroke: Atherosclerosis Risk In Communities Study

dental caries, infection
two dental models one healthy and another with caries
To determine whether dental caries are associated with ischemic stroke and specific ischemic stroke subtypes, researchers evaluated participants of the Atherosclerosis Risk In Communities (ARIC) study.

The following article is part of conference coverage from the American Academy of Neurology (AAN) 2021 Virtual Annual Meeting. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from the AAN 2021 Virtual Annual Meeting.


Dental caries are associated with ischemic stroke, according to a prospective cohort study presented at the American Academy of Neurology Virtual Annual Meeting, held April 17-22, 2021.

Although periodontal disease (PD) is an independent risk factor for ischemic stroke, dental caries, defined as the infection of teeth, is pathophysiologically distinct from PD and only limited data are available to link the infection with ischemic stroke.

Study researchers performed full-mouth clinical exams to determine the presence of dental caries in 6326 study participants without prior stroke from the dental cohort of the Atherosclerosis Risk in Communities (ARIC) study.

They assessed stroke diagnoses based on computer-derived diagnoses and physician medical record review. A second physician resolved any differences. Strokes were classified by etiologic subtype: thrombotic, lacunar, and cardioembolic stroke.

At the fourth ARIC study visit, 1146 of the 6326 participants had evidence of coronal dental caries. Of the 393 ischemic strokes that occurred from 1996 to 2016, 153 (52%) were thrombotic, 80 (20%) were cardioembolic, and 67 (17%) were lacunar strokes.

Participants who had at least 1 coronal dental caries (hazard ratio [HR], 1.9; 95% CI, 1.5-2.4) had an increased risk of incident ischemic stroke compared with those without dental caries.

After adjusting for age, race, gender, body mass index, diabetes, smoking status, education, and presence of PD, the association remained significant (HR, 1.4; 95% CI, 1.1-1.8). Findings suggested an independent association for cardioembolic stroke (HR, 2.2; 95% CI, 1.3-3.6) but not for thrombotic or lacunar stroke.

Study researchers concluded that their findings, “demonstrate an independent association between dental caries and ischemic stroke.” This association, they added “was independent of PD.”


Sen S, Curtis J, Hicklin D, et al. Dental caries associated with incident ischemic stroke: atherosclerosis risk in communities study. Presented at: the American Academy of Neurology 2021 Virtual Annual Meeting; April 17-22, 2021. Abstract S22.005