Periodontal disease may be linked to a higher risk of stroke, but proper dental biofilm control may help. This large systematic review was recently published in the Journal of Evidence-Based Dental Practice.
However, more research is needed to determine the underlying mechanisms by which gum disease raises one’s stroke risk, the authors wrote.
“Periodontal disease has been identified as an independent risk factor for stroke,” wrote the authors, led by Yuqing Zhang of the Capital Medical University School of Stomatology in China (J Evid-Based Dent, June 18, 2025, 102172).
To explore the link between periodontal disease and stroke, researchers conducted a systematic review that yielded 36 studies with a combined total of over 7 million participants, comprising cohort, case-control, and cross-sectional designs, they wrote.
Included studies focused on populations without other systemic or physical/mental conditions, with periodontal disease as the exposure and stroke as the outcome. Healthy individuals without periodontal disease served as the comparison group.
Patients with periodontal disease had a significantly higher risk of stroke compared to healthy individuals (odds ratio [OR], 1.724; 95% confidence interval [CI], 1.481 to 2.008; p < 0.001). Additionally, patients with periodontitis faced a higher stroke risk than those with gingivitis (OR: 2.008 vs. 1.673), and the risk was greater for ischemic stroke than hemorrhagic stroke (OR: 1.846 versus 1.476), they wrote.
Sensitivity and cumulative meta-analyses, along with publication bias assessments (Egger’s test p = 0.280; Begg’s test p = 0.703), confirmed the stability of the results. While periodontal disease was linked to stroke risk, the underlying mechanisms behind this association could not be fully understood.
However, the review had limitations. High heterogeneity was observed in the pooled results, potentially due to variations in study designs, the authors added.
“Regular and effective dental biofilm control may help reduce the risk of stroke in patients with periodontal disease,” they concluded.
