Gum health treatments may reduce the risk of ischemic stroke, indicating that maintaining good oral health could play a role in stroke prevention. This review was recently published in the International Journal of Dental Hygiene.
Furthermore, noninvasive oral health practices such as regular toothbrushing and routine dental care appear to be linked to a lower risk of ischemic stroke, with tooth scaling showing a statistically significant protective effect, the authors wrote.
“There is moderate certainty of a favourable effect of periodontal health interventions in general, and tooth scaling specifically, in reducing the risk of ischemic stroke,” wrote the study’s lead author, Jorge Moldes of the Pontevedra University Clinical Hospital in Spain (Int J Dent Hyg, April 20, 2026).
The review aimed to examine the evidence linking periodontal health interventions to the risk of ischemic stroke. Researchers searched electronic databases and hand-searched records through January 2025, including clinical trials and observational studies that reported periodontal interventions and ischemic stroke outcomes, they wrote.
All types of periodontal care were considered if they were clearly described and compared with either no treatment or another intervention. The interventions were grouped into categories based on complexity: dental visits, toothbrushing, tooth scaling, scaling and root planing, periodontal surgery, and tooth extraction. Out of 634 initial records, seven studies involving nearly 1.9 million participants met the inclusion criteria.
Periodontal interventions were linked to a lower risk of ischemic stroke, with a hazard ratio (HR) of 0.88 (95% confidence interval [CI]: 0.81 to 0.95). Tooth scaling showed a particularly strong protective effect, reducing stroke risk with an HR of 0.84 (95% CI: 0.76 to 0.92). Also, routine or preventive dental visits were associated with a lower risk compared with episodic or symptom-driven visits (HR: 0.77 [CI: 0.63 to 0.94]), they wrote.
Brushing twice daily lowered the risk compared with brushing once a day or less (HR: 0.89 [CI: 0.84 to 0.95]), and brushing three or more times daily showed an even greater reduction (HR: 0.81 [CI: 0.76 to 0.87]). While scaling and root planing and periodontal flap surgery showed no significant difference compared with tooth scaling (HR: 0.62 [CI: 0.31 to 1.25]), tooth extraction was linked to a higher risk of ischemic stroke (HR: 1.56 [CI: 1.19 to 2.03]).
Nevertheless, the study had limitations. Although broad search terms were used to improve sensitivity, the limited use of controlled vocabulary may have reduced the overall comprehensiveness of the search strategy, the authors added.
“Those results provide a more solid basis for the formulation of therapeutic recommendations and open avenues for further research into population subgroups, clinical stages, specific treatments and the utility of periodontal disease screening systems,” Moldes and his team concluded.
