Subpar utilization of dental care among Americans with a history of stroke

Abstract

Persons with poor oral hygiene are prone to periodontitis, an inflammatory gum disease independently linked to stroke. Regular dental examinations allow for early detection and treatment of oral conditions associated with the risk of further vascular events. Little is known about patterns of dental care among persons at risk for stroke. We assessed the prevalence and independent predictors of at least one visit to the dentist within the preceding 12 months among stroke survivors in the United States using data from the National Health Interview Survey (NHIS) 2006 survey. The 24,275 adults who completed the survey self-reported a total of 706 strokes, for an incidence of 3%. The rate of at least one visit to the dentist over the previous year among stroke survivors (mean age, 67 +/- 15 years) was 46%. Factors independently associated with visiting the dentist were female sex (odds ratio [OR], 1.83; 95% confidence interval [CI], 1.31-2.57), being married (OR, 1.95; 95% CI, 1.37-2.77), having a high school or greater education (OR, 2.11; 95% CI, 1.51-2.93), and having contact with a primary care doctor in the previous year (OR, 1.74; 95% Cl, 1.04-2.93). Factors independently associated with not visiting the dentist were black race (OR, 0.63; 95% CI, 0.43-0.92) and the presence of a significant medical comorbidity (OR, 0.69; 95% CI, 0.48-0.97). In 2006, less than half of stroke survivors in the United States received dental care, leaving substantial room for improvement. Stroke survivors need education about the importance of regular dental care, particularly minority groups.