Dental Interventions for Stroke Prevention—A Narrative Review of Literature

ABSTRACT Ischemic stroke represents a leading cause of global mortality and disability, with traditional prevention strategies focusing on cardiovascular risk factor management. Emerging evidence suggests that periodontal disease, through systemic inflammation and bacterial translocation, may contribute to atherosclerotic plaque formation and stroke risk. This narrative review synthesizes current evidence examining dental interventions for stroke prevention, with particular emphasis on interventional studies. Large population‐based cohort studies from Taiwan and South Korea demonstrate that routine oral hygiene practices, including regular toothbrushing and professional dental prophylaxis, are associated with significant stroke risk reduction ranging from 9% to 60%, with dose–response relationships evident across multiple studies. Professional tooth scaling (≥ 2 times annually) confers the greatest protective effect (hazard ratio 0.40, 95% CI 0.29–0.57). Randomized controlled trials reveal that intensive periodontal therapy improves cardiovascular surrogate markers, including carotid intima‐media thickness progression, endothelial function, and blood pressure control. However, the PREMIERS trial failed to demonstrate reduced recurrent vascular events following intensive periodontal treatment in stroke survivors, likely due to insufficient statistical power. The convergent evidence from observational and mechanistic studies supports dental interventions as a potentially valuable, accessible, and cost‐effective component of comprehensive stroke prevention strategies, warranting further investigation through adequately powered randomized controlled trials.