Researchers have been exploring links between dental health and stroke risk for decades.
New research out of the University of South Carolina reveals that people with both periodontal disease (PD) and dental caries face a much higher risk of ischemic stroke and other serious cardiovascular events.
The study, appearing in Neurology: Open Access, offers a more detailed glimpse of how two of the world’s most common chronic oral infections interact to sway long-term vascular health.
A 20-Year Look at Oral Health, Stroke
Working with data culled from nearly 6,000 adults in the long-running Atherosclerosis Risk in Communities (ARIC) study, the research team assessed dental health at midlife and tracked cardiovascular outcomes for more than 20 years. The researchers grouped participants by oral status, based on whether they had good oral health, PD alone, or a combination of PD and dental caries.
None of the participants had a prior history of heart disease or stroke when they entered the study between 1996 and 1998. But by 2019, more than 400 of them had endured at least one ischemic stroke. Others developed myocardial infarctions or fatal coronary events.
More specifically:
- 4.1% of those with healthy mouths suffered a stroke.
- 6.9% of those with PD alone reported a stroke, and
- 10% of those with both PD and caries had a stroke.
After controlling for demographic factors, participants with both gum disease and cavities faced an 86% higher risk of ischemic stroke and a 36% higher risk of major adverse cardiovascular events (MACEs).
The study’s authors reported that the risk stretched across specific stroke subtypes, particularly thrombotic and cardioembolic strokes. For those with PD and caries, the risk of thrombotic stroke more than doubled. The risk of cardioembolic stroke nearly tripled.
“We found that people with both cavities and gum disease had almost twice the risk of stroke when compared to people with good oral health, even after controlling for cardiovascular risk factors,” said study author Souvik Sen, MD, MS, MPH, of the University of South Carolina in Columbia. “These findings suggest that improving oral health may be an important part of stroke prevention efforts.”
Regular Dental Care Makes a Difference
But it wasn’t all bad news. Preventive care made a difference.
Participants who reported regular dental visits appeared to be much less likely to have either gum disease or cavities. Routine dental care reduced the odds of having PD by 29% and PD with caries by a staggering 81%.
These results reinforce earlier findings from the same ARIC population that revealed that regular dental checkups correlated with a 23% lower stroke rate. As a result, the authors suggest that consistent dental hygiene could reduce systemic inflammation and, by extension, vascular risk.
How the Mouth Ties to the Brain
While the mouth-brain link might seem a little nebulous, researchers point to a growing body of evidence that oral infections contribute to systemic inflammation.
Bacteria spawn periodontal disease by inflaming and eroding the tissues that support the teeth, paving the way for pathogens to seep into the bloodstream. Dental caries, driven by acid-producing bacteria such as Streptococcus mutans, can lead to chronic infection and immune activation. Both pathways can damage vessel walls, foster plaque buildup, and promote thrombosis.
The researchers argue that the combined presence of gum disease and tooth decay probably makes things worse by explaining the higher stroke risk in people with both conditions.
A Case for Integrating Dental, Medical Care
Even after accounting for socioeconomic and health variables, oral disease remained an independent predictor of stroke. That finding, the authors insist, supports a stronger push to better integrate oral health into cardiovascular risk assessments.
“This study reinforces the idea that taking care of your teeth and gums isn’t just about your smile,” Sen added, “it could help protect your brain. People with signs of gum disease or cavities should seek treatment not just to preserve their teeth, but potentially to reduce stroke risk.”
The message is a simple (yet strong ) one. Healthy gums and teeth can help protect your heart and brain. Regular dental visits, consistent brushing, and early treatment of oral infections could offer benefits that extend well beyond oral hygiene.
Further Reading
Researchers Find Link Between Rising Stroke Rates and Changing Temperatures
