The Impact of Periodontal Health Interventions on the Risk of Ischemic Stroke: A Systematic Review and Meta-Analysis

Aim: To systematically review the evidence on the relationship between periodontal health interventions and the risk of first-ever ischemic stroke. Materials and Methods: Search strategy included electronic and hand searching to January 2025. MEDLINE (OVID), EMBASE (OVID), SCOPUS, LILACS, Web of Science (WOS) and Cochrane Central Register of Controlled Trials (CENTRAL) were searched. Eligible studies included clinical trials and observational designs reporting on any periodontal health intervention and ischemic stroke. Screening and data extraction were performed independently and in duplicate. Meta-analyses were conducted when appropriate. Results: Seven studies involving 1,886,947 participants met the inclusion criteria from an initial set of 634 records. In a random-effects meta-analysis, periodontal interventions were associated with a lower risk of ischemic stroke (HR: 0.88 [0.81–0.95]). Tooth scaling, in particular, was associated with a reduced risk (HR: 0.84 [0.76–0.92]). Conclusion: Periodontal health interventions—especially tooth scaling—appear to be associated with a lower risk of ischemic stroke. These findings suggest a potential role for periodontal care in stroke prevention. Trial Registration: PROSPERO number: CRD42023450471.