New research suggests that gum disease may be tied to serious risks for both heart and brain health. Two studies published in Neurology Open Access found that poor oral health was associated with brain white matter damage. It was also linked to a higher risk of stroke.
Researchers analyzed data from the long-running Atherosclerosis Risk in Communities (ARIC) study. The study began in 1987 and included nearly 16,000 participants aged 45 to 65.
In one study, adults with gum disease were more likely to show signs of white matter hyperintensities. These changes in the brain are often linked to cerebrovascular disease. White matter hyperintensities are associated with a higher risk of dementia, mortality, and functional decline.
“Gum disease is associated with a higher chance of inflammation, and inflammation has been tied to atherosclerosis as well as hardening of the small blood vessels, as we saw in this study,” said lead author Dr. Souvik Sen of University of South Carolina.
Among 1,143 ARIC participants, periodontal disease was linked to being in the highest quartile of white matter hyperintensity volume. The adjusted odds ratio was 1.56, with a 95% confidence interval of 1.01 to 2.40. In the second study, researchers followed 5,986 people for 21 years.
The incidence of ischemic stroke was 4.1% for people with healthy mouths, 6.9% for those with gum disease, and 10.0% for those with both gum disease and cavities. People with both conditions had an 86% increased risk of ischemic stroke. They also faced a higher risk of major cardiovascular events compared with those with good oral health.
Dr. Leonardo Pantoni of University of Milan wrote an accompanying editorial. He noted that these findings highlight the need to consider oral health in stroke prevention. “The most obvious implication of these data is that oral health plays a role in stroke risk, an already well-documented association, and may contribute to white matter hyperintensity pathogenesis, a relationship that is less well explored,” he said.
Pantoni emphasized that white matter hyperintensities “are in no way a benign neuroimaging finding.” He pointed to their strong links to dementia and other serious health outcomes.
The studies establish an association, but they do not prove causation. However, both Sen and Pantoni said the findings support the idea that oral inflammation may contribute to vascular and neurological damage. Regular dental care and good oral hygiene were tied to lower rates of gum disease and cavities. Sen said the risk of stroke dropped by as much as 81% in those who maintained good oral health.
About 3.5 billion people worldwide suffer from gum disease or cavities, according to World Health Organization. Researchers say prevention and treatment could play an important role in reducing stroke and brain disease risk. More than 795,000 people experience a stroke each year in the U.S., according to American Heart Association.
The researchers said future studies will need to confirm whether targeting oral inflammation can help protect the brain. They also want to see if better oral health can reduce cardiovascular disease risk.