May is American Stroke Month.

First, some quick and sobering facts: Someone in the U.S. has a stroke every 40 seconds, and every four minutes someone dies because of a stroke.

Strokes are the leading cause of long-term disability in the U.S., and can occur at any age. Interestingly, more women than men have fatal strokes, partly because of the use of oral contraceptives. Your risk of a stroke doubles each decade after you reach 55.

So what do strokes have to do with your teeth and gums? Is there a connection, and can improving your oral health prevent things like strokes, heart attacks and other serious health issues? While the idea that problems in the mouth cause diseases elsewhere in the body makes sense, it has been difficult to prove conclusively. Although no direct link has yet been proven, more and more research is pointing to oral health and systemic health being connected.

In people with gum disease, chewing and tooth brushing release bacteria into the bloodstream. Several species of bacteria that cause periodontitis have been found in arterial plaques in the heart and other parts of the body.

This infected arterial plaque is not the same plaque we talk about on your teeth at dental visits, but it does contain some of the same bacteria, and research seems to be pointing toward an increased risk of strokes and heart attacks in people with gum disease. The reasons are not fully understood … yet. What is clear is that while approximately 66 percent of people without heart disease have gum disease, up to 91 percent of people with heart disease have it.

Many researchers are starting to believe that the chronic inflammation present in the mouth of someone with gum disease also leads to inflammation in the lining of the blood vessels. That would be consistent with an increased risk of stroke and heart attack, since an inflamed blood vessel has a smaller opening, and allows less blood to flow. That results in higher blood pressure.

There is a risk for some of that inflamed arterial plaque to break off and travel in the blood stream as a “clot” until it gets trapped somewhere in a heart vessel, causing a heart attack, or in a brain vessel, resulting in a stroke.

Of course, any article written by me will include any applicable health connections to untreated Obstructive Sleep Apnea (OSA). Some of my previous articles have discussed aspects of this deadly and vastly under-diagnosed condition, where the brain and heart are deprived of essential levels of oxygen, hundreds of times per night, due to airway blockages. A CPAP or an oral appliance device can greatly reduce or eliminate the many health risks associated with untreated sleep apnea, including the 300 percent increase in stroke risk.

Further research is needed to determine how OSA increases the risk of a stroke.

To summarize, if you haven’t had a full dental exam in a year or more; one that includes careful measurement of your periodontal pockets, bone and bleeding levels, it’s time to make an appointment. That now appears to be particularly true if you have a family history of heart disease or stroke, in light of the research that is being done in this area.

What happens after you or a loved one has had a stroke? How does that impact the ability to care for your mouth? The answer is, “it depends.” The severity of your stroke, and how quickly you were able to receive definitive emergency medical care will have a significant impact on how much damage to your brain occurs, and how much of your function will be able to regain with appropriate rehabilitation therapy.

Some stroke victims go on to a complete recovery, some have minor residual problems, some have major brain damage, and some people die from their first (and only) stroke. Those who have experienced significant damage from a stroke will require assistance to properly care for their teeth and gums, along with many other body care issues, including dressing and eating.

Sadly, proper oral care is often not a top priority with caregivers, as it can be difficult to accomplish due to patient cooperation as well as the exhausting overall demands on their time. If you have someone you love in a care facility, one of the most helpful things you could do for them would be to take the time to brush and floss their teeth as part of your visits. Your loved one will be healthier, and the staff will likely be grateful for your help.

Prompt recognition of the signs and symptoms of a stroke are critical to maximizing treatment success. Here are the signs, made easier to remember by the acronym FAST:

• Face: Can the person smile evenly or does one side droop?

• Arms: Is one numb or weak, or does one drift down?

• Speech: Can they repeat a simply phrase or is their speech slurred or strange?

• Time for 911: Speed of diagnosis and treatment is critical. If you see any of these signs, call 911 immediately. You may save a life, or dramatically increase the chances of a meaningful recovery.

For more information on stroke, the following websites contain helpful information. www.StrokeAwarenessFoundation.us and www.strokeassociation.org.

Dr. Stuart Rich owns Simply Smiles, a general dental practice in Auburn. He and his team, including associate Dr. Jennifer Fields, treat patients of all ages. He also assists sleep specialist physicians in providing an alternative to the CPAP machine for those with Obstructive Sleep Apnea. For more information, visit www.SimplySmilesAuburn.com or www.SleepSolutionsNW.com. You may also email them at info@SimplySmilesAuburn.com, or call 253-939-6900.