New studies link oral health to cerebrovascular health

Dental Tribune International

Mon. 3. November 2025

save

COLUMBIA, S.C., US: Growing evidence continues to demonstrate the far-reaching impact of oral health on systemic well-being. Just recently, two new studies have strengthened the association between periodontal disease, dental caries and cerebrovascular health, suggesting that maintaining healthy teeth and gingivae may help reduce vascular injury in the brain and lower the risk of stroke.

The first study found that adults with periodontal disease had significantly greater signs of microvascular brain injury. Additionally, the second study reported that participants with both caries and periodontal disease had a higher incidence of ischemic stroke. Both studies highlight the importance of improving oral health in order to mitigate vascular risk factors that can affect the brain.

Previous research has linked periodontitis to a higher risk of ischemic stroke. Likewise, cerebral small vessel disease has been independently associated with ischemic stroke. Therefore, the researchers in the first study investigated whether the two diseases are independently associated. They took MRI brain scans of 1,143 adults with an average age of 77 to look for signs of cerebral small vessel disease—damage to the brain’s small blood vessels that can appear as white matter hyperintensities (bright spots on MRI linked to poor blood flow), cerebral micro-bleeds or previous lacunar infarcts. These brain changes become more common with age and are associated with increased risk of stroke, cognitive impairment and mobility issues.

According to the findings, the participants with periodontal disease had a statistically significantly greater volume of white matter hyperintensities. The difference in volume (as a percentage of brain volume) between those with and without periodontal disease was small but clinically meaningful. These lesions were more extensive among participants with periodontal disease even after adjusting for major vascular risk factors. However, no significant links were found between periodontal disease and cerebral micro-bleeds and lacunar infarcts once confounding factors had been taken into account.

“If future studies confirm this link, it could offer a new avenue for reducing cerebral small vessel disease by targeting oral inflammation,” senior author Prof. Souvik Sen, chair of the neurology department in the School of Medicine Columbia at the University of South Carolina, said in a press release. “For now, it underscores how dental care may support long-term brain health,” he concluded.

The study, titled “Periodontal disease independently associated with white matter hyperintensity volume: A measure of cerebral small vessel disease”, was published online in the December 2025 issue of Neurology.

Caries and periodontal disease may increase stroke risk

In the second study, involving 5,986 adults with an average age of 63, the researchers examined whether periodontal disease in combination with dental caries or alone was associated with later risk of ischemic stroke. The participants had no prior history of stroke at baseline and were followed for about two decades to determine which participants had experienced a stroke.

The findings showed that stroke incidence followed an oral health gradient: being lowest among the participants with healthy mouths and highest among the participants with both periodontal disease and caries. After the researchers adjusted for major vascular risk factors, participants with both periodontal disease and caries had nearly double the risk of ischemic stroke compared with those with good oral health. Additionally, those with periodontal disease alone had a significantly elevated risk.

“The findings indicate that periodontitis and caries together are independently linked to higher risk of ischemic stroke. For dental professionals, this underscores the systemic relevance of comprehensive preventive care.” Prof. Sen, who was also the senior author of the second study, said in a press release.

The study, titled “Combined influence of dental caries and periodontal disease on ischemic stroke risk”, was published online in the December 2025 issue of Neurology.