Stroke is a disease that affects the arteries leading to and within the brain. There are two types of stroke. Ischemic stroke occurs when a clot obstructs blood flow to the brain. This is the most common type of stroke. You can think of an ischemic stroke and a heart attack (MI) as being very similar. In both cases, blood flow is interrupted to the target organ. When this happens in the heart, a heart attack (MI) occurs. When this happens in the brain, a stroke occurs. A transient ischemic attack (TIA) or “mini stroke” is caused by a temporary clot in a vessel. Hemorrhagic stroke occurs when a blood vessel ruptures and prevents blood flow to the brain. If blood cannot reach a part of the brain, the part of the body that is innervated from that area of the brain does not function as it should.
In the United States someone has a stroke every 40 seconds and someone dies from a stroke every 4 minutes. 80% of strokes are preventable. Chronic inflammation is a contributing factor to stroke pathogenesis.
TREATMENT FOR STROKES:
Hemorrhagic strokes are treated with surgical and non surgical methods to stop the bleeding in the brain and reduce intracranial pressure.
Treatment of ischemic strokes is aimed at breaking up an existing blood clot and preventing the development of new blood clots. The emergency drug used to dissolve a clot is tissue plasminogen activator (TPA). For best results this drug must be administered with 3 hours of symptom onset. Long term management of strokes is done with anticoagulants such as Coumadin or Coumadin substitutes (Pradaza, Eliquis, Xarelto). Anticoagulants interfere with the proteins (Factors) in the blood that are involved with the coagulation process. Another class of drugs to prevent strokes are the antiplatelets such as aspirin, Plavix or Plavix substitutes (Effient, Brilinta). These drugs work by making the surface of platelets slippery (prevent secondary granular release) so they cannot clump together to form a clot.
PERIODONTAL DISEASE AND STROKES
Periodontal care is very important in stroke prevention and management. Preventing and controlling periodontal inflammation removes one of the major risk factors for stroke. A strict periodontal maintenance program will reduce the need for invasive dental surgical procedures (extraction, implant placement, periodontal surgery). If these procedures are necessary, the patient may be taken off of their anticoagulant and antiplatelet medications which puts him/her at risk for repeat stroke. The other alternative is to stay on the medications and run the risk of free bleeding during and/or after the invasive dental procedure.
At Britt Perio, we have effective methods to reduce inflammation to reduce risk of having a stroke and also methods to prevent the need for invasive dental surgical procedures which will require discontinuing anticoagulant and antiplatelet medications.