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Original Article
Association between regular dental scaling and stroke risk in patients with periodontal diseases: evidence from a Korean nationwide database
Yu-Rin Kim, Minkook Son, Seon-Rye Kim
Epidemiol Health. 2025;47:e2025020.   Published online April 19, 2025
DOI: https://doi.org/10.4178/epih.e2025020
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study aimed to evaluate the association between the frequency of dental scaling and the risk of stroke among individuals with moderate-to-severe periodontal diseases and verify the effect of regular dental scaling on stroke risk in this population.
METHODS
In this retrospective study, 25,758 subjects with moderate-to-severe periodontal diseases were selected from the Korean National Health Insurance Service-National Health Screening Cohort database. Based on the frequency of dental scaling, the subjects were divided into three groups: regular, occasional, and infrequent. Restricted cubic splines were used to evaluate hazard ratios (HRs) with 95% confidence intervals (CIs) for stroke. Additionally, landmark analysis was conducted to strengthen the reliability of the results.
RESULTS
There were 293, 111, and 38 stroke cases in the infrequent, occasional, and regular group, respectively. The adjusted HR for stroke in the regular group, compared to that in the infrequent group, was 0.40 (95% CI, 0.29 to 0.57). In the landmark analysis with follow-up after 1 year and after 2 years, the adjusted HR in the regular group compared to that in the infrequent group was 0.41 (95% CI, 0.28 to 0.60) and 0.50 (95% CI, 0.33 to 0.76), respectively.
CONCLUSIONS
Regular dental scaling was significantly associated with a reduced risk of stroke in patients with moderate-to-severe periodontal diseases. These findings may suggest a potential preventive role of dental scaling beyond oral health. Further studies are needed to explore the underlying biological mechanisms linking periodontal care to stroke prevention and to explore causal relationships between dental scaling and stroke risk.
Summary
Korean summary
중등도 이상의 치주염을 가진 성인을 대상으로 분석한 결과, 정기적으로 치석 제거(스케일링)를 시행한 집단은 비정기적 또는 미시행 집단에 비해 뇌졸중 발생 위험이 통계적으로 유의하게 낮은 것으로 나타났다. 이러한 보호 효과는 특히 남성 및 65세 이상 고령층에서 더욱 뚜렷하게 관찰되었다. 본 결과는 정기적인 구강건강관리가 뇌혈관질환 예방에 있어 잠재적인 기여 요인임을 시사한다.
Key Message
Among adults with moderate to severe periodontitis, those who underwent regular dental scaling had a significantly lower risk of stroke compared to those without routine scaling. This protective effect was especially evident in males and individuals aged 65 and older. These results suggest that regular oral healthcare may serve as a potential contributing factor in the prevention of cerebrovascular diseases.

Citations

Citations to this article as recorded by  
  • Dental Interventions for Stroke Prevention—A Narrative Review of Literature
    Anita Siewko, Szymon J. Jurga, Maksymilian A. Brzezicki, Izabela Wojtasz, Anita Nowak, Gabriel Slonina, Iwona Towpik, Lukasz Dzieciuchowicz, Radoslaw Kazmierski
    Neurology and Clinical Neuroscience.2026;[Epub]     CrossRef
  • Periodontitis and risk of stroke: a systematic review and meta-analysis of observational studies
    Xinyu Meng, Xiaohua Chen
    Frontiers in Neurology.2025;[Epub]     CrossRef
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