Healthcare (Commonwealth Union) – It has long been known that good oral health goes beyond a perfect smile and the maintenance of oral hygiene, where it extends to various other parts of our health. Recent research as found how it may play a role in strokes.
People who have both tooth decay and periodontal disease may be at an increased risk of ischemic stroke, according to research released on October 22, 2025, in Neurology Open Access, a journal of the American Academy of Neurology. The study does not establish that poor dental health directly causes strokes — it only identifies a correlation.
Ischemic strokes are the most frequently occurring form of stroke. They develop when a clot or obstruction limits blood supply to the brain, cutting off oxygen and essential nutrients.
Tooth decay refers to damage or holes in the enamel, often triggered by sugary or starchy diets, inadequate brushing and flossing, or inherited factors. Gum disease — commonly the result of insufficient oral care — is an infection or inflammation of the gum tissue and the supporting bone, which in advanced cases can cause teeth to fall out.
The lead author Souvik Sen, MD, MS, MPH, of the University of South Carolina in Columbia indicated that they observed that individuals with both tooth decay and gum disease had nearly double the risk of stroke compared to people with healthy mouths, even after adjusting for cardiovascular risks.
He further pointed out that their results indicate that better oral hygiene may play an important role in strategies to prevent stroke.
The study examined records from 5,986 adults, averaging 63 years of age, who had never experienced a stroke when the research began. Each person underwent a dental check-up to determine whether they had gum disease, tooth decay, or both. Based on the findings, participants were sorted into three categories: good oral health, gum disease only, or gum disease combined with cavities.
The researchers monitored these individuals for roughly 20 years, checking in by phone and reviewing medical files to identify who eventually suffered a stroke.
Among the 1,640 people with healthy teeth and gums, 4 percent experienced a stroke. In the group of 3,151 individuals with gum disease alone, 7 percent had a stroke. And in the group of 1,195 people who had both gum disease and cavities, the stroke rate was 10 percent.
After taking into account variables like age, BMI and smoking habits, the researchers observed that compared to people with good oral health, individuals who had both periodontal disease and tooth decay were 86 percent more likely to suffer a stroke. People who had gum disease only faced a 44 percent elevated risk.
The analysis also widened in scope and showed that those with both gum disease and cavities had a 36 percent greater likelihood of experiencing a major cardiovascular event — including heart attack, fatal heart disease or stroke — than people with healthy mouths.
Participants who said they attended dental check-ups regularly had an 81 percent lower chance of having both gum disease and cavities, and a 29 percent reduced chance of having gum disease alone.
“This study reinforces the idea that taking care of your teeth and gums isn’t just about your smile; it could help protect your brain,” explained Sen. “People with signs of gum disease or cavities should seek treatment not just to preserve their teeth, but potentially to reduce stroke risk.”
A key limitation given by the researchers was that they evaluated participants’ oral health only at the beginning, meaning any changes in dental condition over the years were not recorded. They further indicated that it also possible that other health factors that were not measured may have influenced the results.
