Gum Disease, Heart Attack, and Stroke: How Are They Related

Gum Disease, Heart Attack, and Stroke: How Are They Related
profile picture of Dr. Jay Khorsandi, DDS
Gum Disease, Heart Attack, and Stroke: How Are They RelatedClinical Content Reviewed by Dr. Jay Khorsandi, DDS
Last Modified:

Clinical content featured by Byte is reviewed and fact-checked by a licensed dentist or orthodontist to help ensure clinical accuracy.

We follow strict sourcing guidelines and each page contains a full list of sources for complete transparency.

Table of Contents

  1. How Are Oral Health & Stroke Linked?
  2. Prevention
  3. Complications After a Stroke
  4. Tips for Good Oral Hygiene After a Stroke
  5. Frequently Asked Questions
  6. References
A stroke is a cardiovascular event that can cause permanent changes in a person’s motor function, cognitive ability and general ability to live an independent life. It happens when the blood supply to part of your brain is interrupted due to a blood clot or a leak. Medical professionals estimate that 1 in 4 people will have a stroke at some point in their life.
While anyone can be at risk for having a stroke, specific risk factors make some people more likely than others to have one. Studies suggest that gum disease may be one of these risk factors.
Maintain good oral hygiene both before and after a stroke to minimize your risk of further problems.

How Are Oral Health and Stroke Linked?

Over the years, researchers have consistently found a link between gum disease (specifically periodontitis, the most advanced form of gum disease) and stroke. Current estimates suggest that having gum disease makes you two to three times more likely to have a stroke than a person with healthy gums.

Researchers have not reached any decisive conclusions about how the relationship between these two factors works. They do not know if gum disease causes strokes, if there is a common underlying factor that makes a person more susceptible to both conditions or if anything else about what might be causing the relationship. Their best guess is that the long-term inflammation caused by gum disease burdens the body’s immune system and contributes to heart problems like stroke.

How to Prevent Gum Disease 

Avoiding gum disease is a good idea for your oral health and heart health. You can prevent gum disease by: 

  • Brushing your teeth at least twice a day for at least two minutes each time.
  • Flossing your teeth at least once a day. Take care to slide the floss all the way down the tooth each time to clean under the gumline on each tooth.
  • Eating a diet that is low in carbohydrates to avoid feeding the bacteria in your mouth.
  • Avoiding snacking outside of meals.
  • Using mouthwash periodically throughout the day.
  • Not smoking or chewing tobacco.
  • Visiting your dentist for cleanings at least once every 6 months.

If you already have early-stage gum disease (gingivitis), these tips can also help you reverse your condition and recover your oral health.

Oral Health Complications After a Stroke 

People who have had a stroke often face many oral health challenges during their recovery. They usually experience some lasting sensory and motor functioning difficulties, including: 

  • Muscle weakness 
  • Lack of coordination, especially with fine motor movements 
  • Paralysis of the tongue and mouth 
  • Lack of sensation in the mouth 

These problems can make it difficult to brush properly or even hold a toothbrush. They may also make it difficult to recognize that there are leftover food particles in the mouth that should be brushed away.

Some patients experience significant cognitive issues after a stroke. They may be easily confused or disoriented, making it difficult for them to maintain an oral hygiene routine or even to recognize objects like a toothbrush or their dentures.

Many people who have had a stroke also develop anxiety and depression, which can impact their motivation to care for their oral health. Even if they are physically able to brush and floss on their own, they may not be able to muster up the energy to do it.

Finally, many stroke patients are prescribed several medications during their recovery to help improve their functioning and reduce their chances of having another stroke. Xerostomia (or dry mouth) is a common side effect of these medications. This condition robs people of the protective effects of their saliva and significantly increases their risk of gum disease and cavities.

Tips for Good Oral Hygiene After a Stroke

If you or your loved one have had a stroke, you will need to adapt your oral hygiene routine in response. Here are some things you can do to make oral hygiene easier after a stroke.

  • Create a structured environment for oral hygiene activities. Use the same sink in the same bathroom or kitchen each time you brush. Keep the toothbrush, floss, and other oral hygiene aids out on the counter to show what that space is for.  
  • Use an electric toothbrush instead of a manual one. Electric brushes are easier to hold, don't require as much motor coordination to use, and provide a superior clean that helps keep gum disease under control.
  • Consider using floss picks or a water flossed instead of string floss. These tools may be easier for stroke patients to hold and maneuver.
  • Consider supplementing good oral hygiene practices with a chlorhexidine rinse.  

Acknowledge when help is needed. Nearly 84% of stroke patients require help from another person to complete their oral hygiene routine. It may be necessary to have another person take over some oral hygiene tasks to keep the stroke patient’s oral health in check.

Frequently Asked Questions

Can dental problems cause a stroke?
As far as scientists know, dental problems cannot cause a stroke However, having dental problems may make you more likely to have one. The exact relationship between oral disease and stroke is still unclear. Scientists do know that there is a strong link between the two, though, so taking care of your oral health is a good step toward lowering your chances of having a stroke.
How do stroke patients maintain good oral hygiene?
Stroke patients usually need help from their caregivers to maintain good oral hygiene. There are several strategies that caretakers can use to encourage stroke patients to work on their oral hygiene more independently, including using adapted tools and creating an oral hygiene routine.
How long after a stroke can you get dental work done?

Doctors generally recommend that you wait six to 12 months after having a stroke to have any invasive dental work done. This is intended to minimize the risk that you will have another stroke.

However, stroke patients who are closely monitored by medical professionals may be able to safely receive treatment within just a few weeks of their stroke if needed.

If you or your loved one have had a stroke and need to get dental work done, talk to your doctor and dentist about your situation. Together, they may be able to come up with a solution that allows you to take care of your teeth sooner without risking your health.

References 

Stroke – Symptoms and Causes. (February 2021). Mayo Clinic.

Guidelines for the Oral Healthcare of Stroke Survivors. (2010). British Society of Gerodontology.

A new management approach for dental treatment after a cerebrovascular event: a comparative retrospective study. (June 2010). Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics.

Stroke and oral health. (September 2008). Vital.

Periodontitis As A Risk Factor For Stroke: A Systematic Review And Meta-Analysis. (November 2019). Vascular Health and Risk Management.

Gum disease and heart disease: The common thread. (February 2021). Harvard Health Publishing.

Gum Disease. (March 2020). HealthLink BC.

Stroke. (June 2017). College of Dental Hygienists of Ontario.

Improving oral hygiene for stroke patients. (May 2017). Australian Journal of Neuroscience.

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

TOP