Yago Leira Feijóo
Doctor of Dentistry, Miguel Servet researcher in the field of Stomatology at the Department of Surgery and Medical-Surgical Specialities at the University of Santiago de Compostela
Is the study based on solid data and methods?
"This study is an analysis of data from the ARIC study combining dental and neurological variables. This study presents a rigorous and correct methodology for the hypothesis to be tested by the authors. In addition, it includes a 15-year follow-up of the participants. This makes the study design ideal for investigating whether, in this particular case, periodontitis may be a risk factor for white matter lesions.‘
How does it fit in with previous work? What new information does it provide?
’There are previous studies that associate tooth loss or edentulism with white matter lesions in the brain. However, this study provides new prospective (longitudinal) evidence on the effect of periodontitis on this type of lesion.‘
Are there any important limitations to consider?
’The definition used in the study for cases of periodontitis is not the one recommended by the American Academy of Periodontology and the European Federation of Periodontology. In the study, the prevalence of periodontitis is 70%, which seems a little high compared to other epidemiological studies and may overestimate the number of cases of periodontitis. Furthermore, the analysis does not include the different degrees of severity of periodontitis (mild, moderate and advanced), which would provide more information for the study. Based on previous studies, it is the more advanced forms that are associated with neurological diseases such as stroke or dementia. Regarding the analysis of other forms of small vessel brain disease, the authors did not find statistically significant results. The small sample size of patients with microbleeds (25%) or lacunar stroke (17%) may have influenced these results.