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Original article Association between regular dental scaling and stroke risk in patients with periodontal diseases: evidence from a Korean nationwide database
Yu-Rin Kim1orcid , Minkook Son2orcid , Seon-Rye Kim3orcid
Epidemiol Health 2025;e2025020
DOI: https://doi.org/10.4178/epih.e2025020 [Accepted]
Published online: April 19, 2025
1Department of Dental Hygiene, Silla University, Busan, Korea
2Department of Physiology, College of Medicine, Dong-A University, Busan, Korea
3Institute of Health Medical Education Convergence Research, Kangwon National University, Samcheok-si/Gangwon-do, Korea
Corresponding author:  Seon-Rye Kim,
Email: sjsanj@hanmail.net
Received: 10 December 2024   • Revised: 21 March 2025   • Accepted: 31 March 2025
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Abstract

OBJECTIVES
This study aimed to evaluate the association between the frequency of dental scaling and the risk of stroke among individuals with moderate-to-severe periodontal diseases and verify the effect of regular dental scaling on stroke risk in this population.
METHODS
In this retrospective study, 25,758 subjects with moderate-to-severe periodontal diseases were selected from the Korean National Health Insurance Service-National Health Screening cohort database. Based on the frequency of dental scaling, the subjects were divided into three groups: regular, occasional, and infrequent. Restricted cubic splines were used to evaluate hazard ratios (HR) with 95% confidence intervals (CI) for stroke. Additionally, landmark analysis was conducted to strengthen the reliability of the results.
RESULTS
There were 293, 111, and 38 stroke cases in the infrequent, occasional, and regular group, respectively. The adjusted HR for stroke in the regular group, compared to that in the infrequent group, was 0.40 (95% CI, 0.29–0.57). In the landmark analysis with follow-up after 1 year and after 2 years, the adjusted HR in the regular group compared to that in the infrequent group was 0.41 (95% CI, 0.28–0.60) and 0.50 (95% CI, 0.33–0.76), respectively.
CONCLUSIONS
Regular dental scaling was significantly associated with a reduced risk of stroke in patients with moderate-to-severe periodontal diseases. These findings may suggest a potential preventive role of dental scaling beyond oral health. Further studies are needed to explore the underlying biological mechanisms linking periodontal care to stroke prevention and to explore causal relationships between dental scaling and stroke risk.

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