Link Between Oral Health and Stroke Risk Highlighted in Long-Term Study
A recent study published in Neurology® Journal has revealed a significant association between poor oral health – specifically periodontal disease (PD) and dental caries (cavities) – and an increased risk of stroke and major adverse cardiovascular events (MACEs). the study, dubbed DARIC, analyzed data from nearly 6,000 participants initially enrolled in the Atherosclerosis Risk in Communities (ARIC) study, with follow-up spanning a median of 21 years.
Researchers categorized participants based on their oral health status as assessed between 1996 and 1998: good oral health (1640 participants), periodontal disease only (3151 participants), or periodontal disease with caries (1195 participants). The average age of participants was 63 years, with 52% being female.
The analysis, adjusted for demographics and existing vascular risk factors, demonstrated a significant increase in stroke risk for those with compromised oral health. Participants with both PD and caries experienced an 86% higher risk of ischemic stroke compared to those with good oral health. Individuals with PD alone showed a 44% increased risk. Specifically, 4% of those with good oral health experienced a stroke, rising to 7% among those with gum disease and 10% among those with both gum disease and cavities.
Beyond stroke, the study also found elevated risks of MACEs. Participants with PD alone had a 47% increased risk, while those with both PD and caries faced an 88% increased risk. Subtype analysis of stroke revealed particularly strong associations with thrombotic stroke [HR 1.81 (95% CI, 1.05-3.10) for PD only; HR 2.27 (95% CI, 1.22-4.24) for PD with caries] and cardioembolic stroke [HR 1.82 (95% CI, 1.00-3.33) for PD only; HR 2.58 (95% CI, 1.27-5.26) for PD with caries].
“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,” stated Souvik Sen, MD, MS, MPH, a professor of neurology at the University of South Carolina School of Medicine and senior author of the study.
Researchers emphasize the potential for preventative measures. The study’s discussion highlights the importance of complete oral health as a modifiable factor in cardiovascular and cerebrovascular disease prevention, suggesting that integrating dental care into routine medical assessments and promoting preventive oral hygiene practices could be a valuable strategy for reducing vascular risk at a population level.
The study did acknowledge certain limitations.Participants were younger, had lower BMIs, and reported lower rates of hypertension and diabetes, and also higher levels of education, compared to those excluded from the study. Additionally, the assessment of oral health relied on a single dental evaluation at the study’s outset, and socioeconomic status was approximated using education level.
References:
- wood S., Logue L., Meyer J., et al. Combined Influence of Dental Caries and Periodontal disease on Ischemic Stroke Risk. Neurology Journals. 2025;1(4): e000036 DOI:10.1212/WN9.0000000000000036
- Gum disease and cavities linked to increased stroke risk. New release. American academy of Neurology.october 22, 2025. accessed November 4,2025.https://www.aan.com/PressRoom/home/PressRelease/5290
