Your Oral Health Could Be Putting You at Greater Risk for Stroke, Study Finds

• A new study shows that poor oral health may contribute to declines in brain health, specifically increasing your risk for stroke.
• Oral health affects your overall health, beyond just your mouth.
• Experts explain the findings and how to take better care of your mouth.

While you may think that your flossing frequency is of little consequence, new research shows that maintaining good mouth health may be essential to your brain health, too.

A new study presented at the American Stroke Association International Stroke Conference analyzed the potential link between oral health and brain health among 40,000 adults without a history of stroke enrolled in the U.K. Biobank. Between 2014 and 2021, participants were screened for 105 genetic variants known to predispose people to have cavities, dentures, and missing teeth later in life. Signs of poor brain health, such as damage to the structure and white matter of the brain, were then screened via MRI images. (White matter is the large network of nerve fibers in your brain that allows the exchange of information and communication between different areas of your brain. It’s called “white matter” because the nerve fibers are covered in a protective sheath called myelin, which gives the tissue its white color.)

Researchers found, in their preliminary findings, that people who were genetically prone to cavities, missing teeth, or needing dentures had a higher amount of damage from a silent stroke, meaning a stroke that doesn’t cause any noticeable symptoms, characterized by a 24% increase in the amount of white matter damage visible on the MRI images. Those with overall genetically poor oral health also had increased damage to the structure of the brain, characterized by a 43% change in structural damage visible on the MRI scans.

“Studying oral health is especially important because poor oral health happens frequently and is an easily modifiable risk factor—everyone can effectively improve their oral health with minimal time and financial investment,” says study author Cyprien Rivier, M.D., M.S., a postdoctoral fellow in neurology at the Yale School of Medicine in a press release from the American Heart Association. After analyzing the results, he explains, “Poor oral health may cause declines in brain health, so we need to be extra careful with our oral hygiene because it has implications far beyond the mouth.”

However, this study is preliminary, and Dr. Rivier says that “more evidence needs to be gathered—ideally through clinical trials—to confirm improving oral health in the population will lead to brain health benefits.”

What are signs of poor oral health?

Poor oral health is typically defined as an imbalance between the health of the teeth, gums, and other structures in the mouth, says Michael J. Wei, D.D.S., Manhattan cosmetic dentist and smile specialist. “It can be caused by a variety of factors, including improper brushing and flossing, poor diet, and inadequate access to dental care.”

Poor oral health can present itself in different ways, says Nicole Mackie, D.D.S., M.S., F.A.C.P., board-certified prosthodontist and dental implant specialist. “Poor oral health can be tooth decay/cavities, periodontal/gum disease, and oral cancer. Some signs can be breaking or broken down teeth, pain, bleeding gums, swollen gums, loose teeth, bad breath, and visible growths on the teeth or in the mouth.” White tongue, or a white filmy appearance on your tongue, is also an indicator of poor oral health, adds Parul D. Makkar, D.D.S., founder of PDM Family Dental.

How can oral health affect brain health?

In the mouth, there are good bacteria and bad bacteria, says Makkar. “Build-up from plaque, infections, or inflammation from broken teeth all carry harmful bacteria that can actually cause hardening of the arteries, leading to blood clots, which can lead to stroke,” she explains.

On another note, the bacteria that cause periodontal disease, or gum disease, can enter the bloodstream and travel to the brain, where it can cause inflammation and damage the brain’s protective barrier, explains Wei. “This inflammation can lead to cognitive decline and impair the ability to think, remember, and learn.” He reiterates that this is how poor oral health may also increase the risk of Alzheimer’s disease and other forms of dementia. “Additionally, gum disease has been linked to stroke and other cardiovascular diseases, which can also lead to problems with brain health.”

How can you take better care of your oral health?

If you’re wondering how you can avoid all the scary consequences that poor oral health might mean for your body and brain, here are some ways you can take better care of your oral health, according to our experts:

• Brush twice a day for two minutes each time, and don’t forget to clean your tongue!
• Floss every day to remove plaque and bacteria from between teeth.
• Visit the dentist regularly for a dental check-up, cleaning, and screenings for oral cancers, periodontal/gum disease, caries, sleep apnea, and TMJ issues.
• Eat a healthy diet, with plenty of solid foods.
• Limit sugary drinks, including soda, concentrated juice, and carbonated water, or use a straw to limit contact with your teeth.
• Limit alcohol use.
• Avoid tobacco products, including smoking cigarettes and vaping.
• Use mouthwash to reduce plaque and bacteria.
• Wear a mouthguard if you play contact sports.
• Consider using an electric toothbrush or water flosser.