People who have both gum disease and caries may face a higher risk of ischemic stroke, according to a study published on October 22, 2025, in Neurology® Open Access, an official journal of the American Academy of Neurology. The study found an association between poor oral health and stroke risk but did not establish a cause-and-effect relationship.
Ischemic strokes, the most common type of stroke, occur when a blockage or clot reduces blood flow to the brain, depriving it of oxygen and nutrients.
Researchers analyzed data from 5,986 adults with an average age of 63 who had no history of stroke when the study began. Participants received dental exams to determine whether they had gum disease, caries, or both. Based on those assessments, participants were categorized into three groups: healthy mouth, gum disease only, and gum disease with caries. They were then followed for two decades through phone visits and medical records to identify who experienced a stroke.
Among the 1,640 participants with healthy mouths, 4% had a stroke. Of the 3,151 people with gum disease only, 7% had a stroke, and among the 1,195 individuals with both gum disease and caries, 10% had a stroke. After adjusting for age, body mass index, smoking status, and other factors, researchers found that people with both gum disease and caries had an 86% higher risk of stroke compared to those with healthy mouths. Those with gum disease alone had a 44% increased risk.
The study also found that participants with both gum disease and caries had a 36% higher risk of major cardiovascular events, including heart attack, fatal heart disease, or stroke, compared to those with healthy mouths. Regular dental visits were associated with 81% lower odds of having both gum disease and caries and 29% lower odds of having gum disease alone.
“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.”
“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,” Sen said. “People with signs of gum disease or cavities should seek treatment not just to preserve their teeth, but potentially to reduce stroke risk.”
According to the study, a limitation was that participants’ oral health was assessed only once, at the beginning of the study, so changes over time were not measured. The authors noted that unmeasured health factors may also have contributed to the findings.
More information on brain health can be found through Brain & Life®, a resource from the American Academy of Neurology that provides information for patients, caregivers, and others interested in brain health through its website, podcast, and publications.
