Cavities and gum disease can nearly double your risk of stroke

• People with gum disease and tooth decay had an 86% greater chance of having a stroke than those with healthy mouths.
• Poor oral health was also associated with a 36% higher risk of heart attacks and other cardiovascular problems.
• Individuals who visited the dentist regularly were 81% less likely to develop gum disease and tooth decay.
• Better oral care could be a simple but often overlooked way to help reduce the risk of stroke, researchers say.

Oral health problems are linked to a higher risk of stroke

People with tooth decay and gum disease may be at greater risk of stroke, according to research published October 22, 2025, in Neuroscience Open AccessOfficial Journal of the American Academy of Neurology. The researchers emphasized that the study shows a link and not a direct cause and effect.

Ischemic strokes occur when a blood clot or blockage restricts the flow of oxygen and nutrients to the brain. They are the most common form of stroke.

Cavities form when bacteria erode tooth enamel, often due to sugary or starchy foods, inadequate brushing, or genetics. Gum disease, also known as periodontal disease, is a chronic inflammation or infection of the gums and bone that support the teeth. If left untreated, it can lead to tooth loss.

“We found that people with tooth decay and gum disease have nearly twice the risk of stroke than 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.”

Long-term study tracks thousands over two decades

The study followed 5,986 adults with an average age of 63, none of whom had initially had a stroke. Each participant underwent dental examinations to determine whether they had gum disease, tooth decay, or both. Based on these results, they were divided into three categories: oral health, gum disease only, and gum disease with tooth decay.

Participants were monitored for 20 years through telephone interviews and reviews of medical records to determine who subsequently had a stroke.

Of the 1,640 participants with healthy mouths, 4% had a stroke. In comparison, 7% of those with gum disease alone and 10% of those with gum disease and tooth decay had a stroke.

The risk of stroke and heart disease increases with poor oral health

After taking variables such as age, body mass index and smoking into account, the researchers found that people with gum disease and tooth decay had an 86% greater risk of stroke than those with healthy mouths. Those with gum disease alone have a 44% higher risk.

Looking beyond strokes, researchers also discovered that people with gum disease and tooth decay face a 36% higher risk of major cardiovascular events, including heart attacks, fatal heart disease or stroke.

Routine visits to the dentist seem to make a big difference. Participants who went to the dentist regularly were 81% less likely to develop gum disease and tooth decay, and had 29% lower odds of developing gum disease alone.

“This study reinforces the idea that taking care of your teeth and gums isn’t just about your smile; it can help protect your brain,” the senator said. “People with signs of gum disease or tooth decay should seek treatment to not only save their teeth, but potentially reduce their risk of stroke.”

Limitations and future research

One limitation of the study is that the researchers assessed the participants’ oral health only once, at the beginning of the study. This means that changes in dental health over time are not measured. The researchers also noted that other unmeasured health or lifestyle factors may have influenced the results.

However, the findings add to growing evidence that oral health and brain health are more closely linked than previously thought.