Stroke / TIA (cerebrovascular disease)

Oral health effects

• Impaired oral hygiene from hemiparesis/facial weakness

  Reduced manual dexterity and lip seal from hemiplegia or facial weakness raise plaque accumulation, caries, and periodontal risk; drooling can also occur.

  Clinical management: Recommend modified or electric toothbrushes, caregiver-assisted hygiene, and shorter, more frequent recall.

• Dysphagia and aspiration risk

  Swallowing difficulty is common after stroke and raises the risk of aspirating oral secretions or debris during treatment.

  Clinical management: Treat in a semi-upright position, use high-volume suction, and use a rubber dam where feasible.

• Aphasia affecting consent and instructions

  Receptive or expressive aphasia can complicate informed consent and following home-care instructions.

  Clinical management: Involve a caregiver or healthcare proxy; use simplified, written, or visual instructions.

• Bleeding risk from secondary-prevention medications

  Most stroke survivors are maintained on long-term antiplatelet or anticoagulant therapy to prevent recurrence, raising bleeding risk with invasive procedures.

  Clinical management: Confirm the current antithrombotic regimen and coordinate with the prescriber before invasive care; see the specific medication for detailed guidance.

• Gum disease as a stroke risk factor (periodontitis association)

  Periodontitis is associated with roughly double the risk of stroke, especially ischemic stroke, so periodontal control matters for secondary prevention.

  Clinical management: Assess and treat periodontitis; set short maintenance intervals; recommend adaptive aids (powered/modified-handle brushes) and caregiver-assisted care when hemiparesis limits hygiene.