The American Heart Association issued a scientific statement in December 2025 connecting periodontal disease to a higher risk of heart attack, stroke, atrial fibrillation, heart failure and cardiac death.
The proposed pathway runs through chronic inflammation and oral bacteria that slip from inflamed gums into the bloodstream.
The statement was chaired by pediatric cardiologist Andrew H. Tran of Nationwide Children's Hospital in Columbus, Ohio. The writing group notes that poor oral hygiene can let bacteria enter the circulation and trigger inflammation that damages blood vessels.
The two conditions also share risk factors. High blood pressure, obesity, diabetes and smoking sit behind gum disease and heart disease alike.
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What the evidence actually shows
A 2020 meta-analysis of 32 cohort studies in the journal Clinical and Experimental Dental Research quantified the link. People with periodontal disease had roughly a 20 percent higher relative risk of cardiovascular disease than those without (RR 1.20, 95% CI 1.14 to 1.26).
The excess risk was clearer for stroke (RR 1.24) than for coronary heart disease (RR 1.14). It was also larger in men and in people with severe gum disease.
That is a modest, not enormous, association. And it is an association, not proof that gum inflammation causes heart attacks.
How gum disease could reach the heart
A 2023 systematic review in Cureus laid out two main routes. Chronic periodontal infection can seed brief bursts of bacteria into the blood. It also raises circulating inflammatory markers such as C-reactive protein (CRP), interleukin-6 and tumor necrosis factor-alpha.
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A broader 2025 review published in the journal Diseases noted that periodontal pathogens including Porphyromonas gingivalis have been detected inside atherosclerotic plaques.
CRP itself reduces nitric oxide availability, the review adds, promoting the stiff, dysfunctional artery lining that sets the stage for atherosclerosis.
Small intervention trials have shown that treating gum disease lowers CRP and improves the flexibility of artery walls. Those biomarker gains are encouraging, but no randomized trial has yet shown that treating gum disease prevents heart attacks.
What gum disease looks like
According to the National Institute of Dental and Craniofacial Research (NIDCR), gum disease is an infection of the tissues that hold teeth in place.
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Early warning signs include gums that are red, swollen, tender or bleeding, persistent bad breath, and gums that pull away from the teeth so they appear longer.
Smoking is the single biggest risk factor, the NIDCR notes, and diabetes and certain medications can also raise risk.
Concrete prevention steps
Prevention advice is straightforward and unglamorous. The NIDCR recommends brushing twice a day with fluoride toothpaste, flossing regularly to clear plaque from between teeth, and going to the dentist for routine check-ups and professional cleanings. Quitting smoking helps too.
If your gums bleed when you brush, or you notice persistent bad breath or receding gums, book a dental appointment. Gum disease is treatable, especially when caught early, and given the growing evidence linking it to cardiovascular risk, that visit is worth putting on the calendar.
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