A landmark American Heart Association statement has drawn a striking line between dental hygiene and cardiovascular risk — and doctors say most people are ignoring it.

For decades, the advice for keeping heart disease at bay has followed a familiar script: eat well, move more, manage stress. But a new scientific statement from the American Heart Association has introduced a less expected protagonist into that story — your toothbrush.

Published in the journal Circulation, the statement presents a compelling case for the role of oral hygiene in cardiovascular health, and it carries a message that cardiologists say is long overdue for mainstream attention. The mouth, it turns out, may be one of the body’s most underestimated windows into heart health.

The Gum Disease Connection

At the center of the AHA’s findings is periodontal disease — a chronic inflammatory condition affecting more than 40 percent of American adults over 30. It begins as gingivitis, the familiar redness and swelling of gums triggered by oral plaque buildup, and can progress to periodontitis, a more serious stage in which gums recede and form pockets that harbor harmful bacteria. Left unchecked, the most advanced form of the disease can cause teeth to loosen and fall out.

The pathway from inflamed gums to a compromised heart is not entirely mysterious. When bacteria from the mouth enter the bloodstream through damaged gum tissue, they can trigger a systemic inflammatory response. That inflammation, over time, stresses arterial walls, accelerates the buildup of arterial plaque and can make existing plaque more prone to rupture — a cascade that may ultimately lead to heart attack or stroke.

Yu-Ming Ni, a cardiologist and lipidologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, Calif., acknowledged that while the link has been known within medical circles for some time, it rarely surfaces in patient conversations. The inflammation caused by gum disease, he noted, does not stay local — it reverberates through the entire cardiovascular system.

What the Science Actually Says About Dental Risk

The AHA was careful to note that a direct cause-and-effect relationship between periodontal disease and heart disease has not been definitively established. What researchers have documented, however, is a robust and consistent association. Multiple independent studies have linked gum disease to elevated risks of heart attack, stroke, atrial fibrillation, heart failure and cardiac mortality.

Justin Zachariah, a co-author of the statement and director of research in Pediatric Cardiology at Texas Children’s Hospital Heart Center, pointed to an additional layer of concern: gum disease appears to worsen established cardiovascular risk factors including diabetes, high blood pressure and elevated cholesterol. Managing oral inflammation, he suggested, may help reduce the broader biological conditions that put the heart under strain.

Hsun-Liang Chan, a professor and chair of the Division of Periodontology at The Ohio State University College of Dentistry, acknowledged that the precise biological mechanisms remain under investigation. Even so, the weight of evidence points clearly enough in one direction: maintaining good oral hygiene and scheduling regular dental visits can help mitigate cardiovascular risk.

How Much Does Dental Care Actually Move the Needle?

Cardiologists are measured in their enthusiasm, but they are not dismissive. Hosam Hmoud, a cardiology fellow at Northwell’s Lenox Hill Hospital, described the contribution of good dental hygiene as additive — not a silver bullet, but a meaningful piece of a larger risk-reduction strategy. Periodontal disease, he and others argue, should be understood as one of many modifiable risk factors for heart disease, sitting alongside diet, exercise, smoking cessation and sleep.

Stephanie Saucier, a cardiologist at Hartford HealthCare, echoed that framing. Perfect dental health will not guarantee a healthy heart, but neglecting oral hygiene is increasingly viewed as a risk that patients — and their doctors — can no longer afford to overlook.

How Often Should You See Your Dentist?

The American Dental Association recommends regular dental visits to reduce the risk of cavities and periodontal disease. For people without a gum disease diagnosis, twice-yearly cleanings are generally sufficient, according to Chan. For those with a prior or current diagnosis, three to four visits per year are recommended given the elevated risk of recurrence. Anyone experiencing dental pain or a new oral health issue should not wait for their next scheduled appointment.

The Bigger Picture: Life’s Essential Eight

For those looking to protect their hearts on multiple fronts, the AHA’s Life’s Essential Eight framework remains the gold standard. It encompasses:

• Eating a diet rich in whole foods, fruits, vegetables, lean protein, nuts, seeds, and healthy oils such as olive and canola.
• Engaging in at least 2.5 hours of moderate-intensity exercise per week.
• Avoiding tobacco in all forms.
• Sleeping seven to nine hours per night.
• Maintaining a healthy weight.
• Controlling cholesterol, with a focus on reducing LDL, or “bad,” cholesterol.
• Managing blood sugar levels.
• Keeping blood pressure below 120/80 mm Hg.

Oral hygiene, while not yet formally enshrined in that list, is increasingly viewed by cardiologists as a natural complement to it. Anyone with concerns about their cardiovascular health is advised to speak with a primary care provider or cardiologist who can evaluate individual risk factors and tailor recommendations accordingly.

As Zachariah noted, every action taken in service of heart health carries value. That now includes the two minutes spent at the bathroom sink each morning and night.

Source: Prevention