Non-Cochrane · intervention · PM42010754
The Impact of Periodontal Health Interventions on the Risk of Ischemic Stroke: A Systematic Review and Meta-Analysis.
Moldes Jorge, Botelho Joao, Rodríguez-Yáñez Manuel, et al. · International journal of dental hygiene · 2026 · PubMed · doi:10.1111/idh.70079
Findings
6 findings
| Population | ||||
|---|---|---|---|---|
| Adults over 65 years | Any periodontal health intervention | No treatment or a different treatment | Incident (first-ever) ischemic stroke Follow-up 3 to 15 years across studies · Population-based cohorts (Taiwan, South Korea, USA, Denmark) · Age over 65 years | HR 0.91 [0.72, 1.14] -8 [-24, 12] per 1000 Very low Downgraded: imprecision, inconsistency 3 studies · 150201 participants |
| Adults over 18 years with or without periodontitis | Any periodontal health intervention (dental visits, toothbrushing, tooth scaling, scaling and root planing, periodontal surgery, tooth extraction) | No treatment or a different treatment | Incident (first-ever) ischemic stroke Follow-up 3 to 15 years across studies · Population-based cohorts (Taiwan, South Korea, USA, Denmark) | HR 0.88 [0.81, 0.95] -6 [-9, -2] per 1000 Moderate 7 studies · 1609327 participants |
| Adults over 18 years with or without periodontitis | Tooth scaling (removal of supragingival plaque) | No tooth scaling | Incident (first-ever) ischemic stroke Follow-up 3 to 15 years across studies · Population-based cohorts (Taiwan, South Korea, USA, Denmark) | HR 0.84 [0.76, 0.92] -6 [-10, -3] per 1000 Moderate 4 studies · 868503 participants |
| Adults over 65 years | Tooth scaling | No tooth scaling | Incident (first-ever) ischemic stroke Follow-up 3 to 15 years across studies · Population-based cohorts (Taiwan, South Korea, USA, Denmark) · Age over 65 years | HR 0.83 [0.57, 1.22] -14 [-36, 18] per 1000 Very low Downgraded: imprecision, inconsistency 2 studies · 79348 participants |
| Adults over 18 years with or without periodontitis | Intensive periodontal treatment (scaling and root planing, periodontal surgery, tooth extraction) | No treatment | Incident (first-ever) ischemic stroke Follow-up 3 to 15 years across studies · Population-based cohorts (Taiwan, South Korea, USA, Denmark) | HR 0.96 [0.78, 1.18] -2 [-12, 10] per 1000 Very low Downgraded: imprecision 3 studies · 505010 participants |
| Special populations (hemodialysis patients; patients with previous myocardial infarction) | Intensive periodontal treatment (scaling and root planing, periodontal surgery) | No treatment | Incident (first-ever) ischemic stroke Follow-up 3 to 15 years across studies · Population-based cohorts (Taiwan, South Korea, USA, Denmark) · Special populations | HR 0.88 [0.69, 1.12] Very low Downgraded: imprecision 2 studies |
Included primary studies 7
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Lin 2019 Dental treatment procedures for periodontal disease and the subsequent risk of ischaemic stroke: A retrospective population-based cohort… PMID:30989681 | 2019 | 1 other review | not stated | not extracted yet |
| Sen 2018 Periodontal Disease, Regular Dental Care Use, and Incident Ischemic Stroke. PMID:29335336 | 2018 | 1 other review | not stated | not extracted yet |
| Chang 2021 Better oral hygiene is associated with lower risk of stroke. PMID:32432793 | 2021 | this review only | not stated | not extracted yet |
| Chen 2012 The association of tooth scaling and decreased cardiovascular disease: a nationwide population-based study. PMID:22483056 | 2012 | this review only | not stated | not extracted yet |
| Huang 2018 Intensive Periodontal Treatment Reduces Risks of Hospitalization for Cardiovascular Disease and All-Cause Mortality in the Hemodialysis… PMID:30314398 | 2018 | this review only | not stated | not extracted yet |
| Lee 2013 Dental prophylaxis and periodontal treatment are protective factors to ischemic stroke. PMID:23422085 | 2013 | this review only | not stated | not extracted yet |
| Wagner 2023 Treated periodontitis and recurrent events after first-time myocardial infarction: A Danish nationwide cohort study. PMID:37464548 | 2023 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Periodontitis as an independent risk factor for cardiovascular disease: a systematic review and meta-analysis. (2026) | 2 | 0.06 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Individuals aged more than 18 years with or without periodontitis | Adults over 18 years in seven cohort studies (n=1,886,947), general community and special populations (haemodialysis, previous myocardial infarction) |
| Intervention | Any periodontal health intervention, invasive (scaling and root planing, periodontal flap surgery, tooth extraction) or non-invasive (dental visits, toothbrushing, tooth scaling) | Dental visits; toothbrushing; tooth scaling; scaling and root planing; periodontal surgery; tooth extraction |
| Comparison | No treatment and/or a different treatment | No intervention or tooth scaling |
| Outcomes | Risk of ischemic stroke | Incident ischemic stroke (hazard ratio) |
| Study designs | Randomized and non-randomized clinical trials, and observational studies (cohort, case-control, cross-sectional) | Seven cohort studies (2 prospective, 5 retrospective) |
| Timing | Not specified | Follow-up 3 to 15 years |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Partial Yes | Yes | no |
| 9Risk of bias assessed satisfactorilycritical | NRSI: Yes · RCT: N/A | NRSI: Yes · RCT: N/A | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | NRSI: No · RCT: N/A | NRSI: No · RCT: N/A | yes |
| 12Impact of risk of bias on the pooled results | Yes | No | no |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Low | yes |