Gum Disease and Cavities Linked to Increased Stroke Risk

The results of a new study published in Neurology Open Access demonstrated that people who have periodontal disease and dental caries have a substantially higher risk of ischemic stroke compared with those who have healthy teeth and gums. The findings suggest that the coexistence of periodontal disease and dental caries—both of which are chronic inflammatory conditions—may potentially contribute to systemic vascular injury and elevate long-term stroke risk. In a press release, the American Association of Neurology (AAN) noted that the findings only demonstrate an association between oral health and stroke, without showing a causative relationship.

The analysis included 5986 adults (mean age, 63 years) enrolled in the Atherosclerosis Risk in Communities (ARIC) study who underwent dental assessments between 1996 and 1998. Participants were classified as having good oral health, periodontal disease alone, or periodontal disease with dental caries. Over a median follow-up of 21 years, investigators tracked incidence of ischemic strokes and stroke subtypes, major cardiovascular events, and utilization of dental care. These outcomes were assessed based on adjudicated medical records and surveys.

Key findings included:

• Ischemic stroke occurred in 4.1% of participants with good oral health (67 of 1640), 6.9% with periodontal disease alone (216 of 3151), and 10% with both conditions (119 of 1195).
• After adjusting for demographics and vascular risk factors, those with both periodontal disease and dental caries had an 86% higher risk of ischemic stroke (HR, 1.86; 95% CI, 1.32 to 2.61) and a 36% increased risk of major cardiovascular events (HR, 1.36; 95% CI, 1.10–1.69) vs those with good oral health.
• Those with periodontal disease alone had a 44% higher risk of ischemic stroke (HR, 1.44; 95% CI, 1.09 to 1.91) vs those with good oral health.
• Elevated risks were most pronounced for thrombotic and cardioembolic stroke subtypes.
• Regular dental care visits were associated with a 29% lower likelihood of periodontal disease and an 81% lower likelihood of having both periodontal disease and dental caries.

Source: American Academy of Neurology. Gum disease and cavities linked to increased stroke risk. American Academy of Neurology. Published October 22, 2025. Accessed November 3, 2025. https://www.aan.com/PressRoom/home/PressRelease/5290

Wood S, Logue L, Meyer J, et al. Combined influence of dental caries and periodontal disease on ischemic stroke risk. Neurol Open Access. 2025;1(4):e000036. doi:10.1212/WN9.0000000000000036.