Cavities and gum disease could nearly double stroke risk

• People with both gum disease and cavities faced an 86% greater chance of having a stroke compared to those with healthy mouths.
• Poor oral health was also tied to a 36% higher likelihood of heart attacks and other cardiovascular problems.
• Individuals who visited the dentist regularly were 81% less likely to have both gum disease and cavities.
• Researchers say better oral care could be a simple yet often overlooked way to help reduce stroke risk.

Oral Health Problems Tied to Higher Stroke Risk

People who have both cavities and gum disease may be more likely to experience an ischemic stroke, according to research published on October 22, 2025, in Neurology Open Access, the official journal of the American Academy of Neurology. The researchers emphasized that the study shows a link rather than direct cause and effect.

Ischemic strokes occur when a blood clot or blockage restricts oxygen and nutrient flow 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 genetic factors. Gum disease, also known as periodontal disease, is a chronic inflammation or infection of the gums and the bone that supports the teeth. Left untreated, it can lead to tooth loss.

"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."

Long-Term Study Tracks Thousands Over Two Decades

The study followed 5,986 adults with an average age of 63, none of whom had experienced a stroke at the start. Each participant underwent dental exams to determine whether they had gum disease, cavities, or both. Based on these findings, they were grouped into three categories: healthy mouth, gum disease only, and gum disease with cavities.

Participants were monitored for 20 years through phone interviews and medical record reviews to identify who later suffered a stroke.

Among 1,640 participants with healthy mouths, 4% had a stroke. In comparison, 7% of those with gum disease alone and 10% of those with both gum disease and cavities experienced a stroke.

Stroke and Heart Disease Risk Rise With Poor Oral Health

After accounting for variables such as age, body mass index, and smoking, the researchers found that people with both gum disease and cavities had an 86% greater risk of stroke than those with healthy mouths. Those with gum disease alone had a 44% higher risk.

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

Routine dental visits appeared to make a major difference. Participants who went to the dentist regularly were 81% less likely to have both gum disease and cavities and had 29% lower odds 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," said Sen. "People with signs of gum disease or cavities should seek treatment not just to preserve their teeth, but potentially to reduce stroke risk."

Limitations and Future Research

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

Still, the findings add to growing evidence that oral health and brain health are more closely connected than once thought.