The link between oral health and brain health: A musician’s journey and the science behind it

Rebekka Manninen, a rock musician from Southern Ostrobothnia, Finland, faced life-changing brain hemorrhages in her late 20s. These events reshaped her perspective on health, underscoring the critical link between oral and brain health.

Rebekka’s life took a sharp turn in 2017 when she suffered a brain hemorrhage. Initially mistaking her symptoms for a migraine, she sought medical help, leading to a diagnosis and treatment. A subsequent scan revealed another aneurysm, treated the following year. During the procedure, Rebekka experienced a stroke but fortunately avoided lasting neurological damage.

These health scares prompted the Finnish musician to reassess her priorities, with a renewed focus on oral health. They also led her to explore the connection between oral bacteria and neurological conditions. While she had always taken care of her teeth, she hadn't previously considered their potential impact on brain health.

Scientific evidence: Oral bacteria and stroke risk

Research reveals a strong connection between oral health and systemic conditions such as strokes and brain hemorrhages. Studies, including those by Professor Pirkko Pussinen at the University of Eastern Finland, show that individuals with severe periodontitis are twice as likely to suffer strokes before age 50, even in the absence of traditional risk factors such as high blood pressure or high cholesterol. Moreover, the severity of strokes often correlates with the extent of gum disease, suggesting that the more advanced the periodontal disease, the more likely it is to lead to a serious cerebrovascular event.^1,2

Medical Licentiate Olli Patrakka’s research further highlights how oral bacteria, especially viridans group streptococci, can enter the bloodstream through inflamed gums, contributing to atherosclerosis and increasing stroke risk. His findings revealed that dental bacteria were present in blood clots in approximately 80% of stroke cases. The findings further suggest that poor oral hygiene, which leads to bacterial buildup in the mouth, can be a significant risk factor for strokes.³

The bigger picture: Interdisciplinary collaboration

Periodontitis, a severe gum condition, is increasingly recognized as a significant risk factor for systemic diseases. Heart and transplant surgeon Tommi Pätilä stresses the importance of collaboration between dentists and doctors to detect and treat hidden oral infections that could help prevent strokes and other health issues.⁴

“In Finland, many doctors already evaluate patients’ oral health and refer them for treatment when necessary. However, stronger collaboration is crucial to addressing oral inflammation early and reducing the prevalence of diseases like strokes,” says Dr. Pätilä.

Innovative approaches to maintaining oral health are also essential. For example, incorporating regular antibacterial treatment has significantly improved oral hygiene and overall health for individuals like Rebekka.^5-7

The Lumoral device (used in European and Asian countries but not yet available in the US) is designed to target hard-to-reach areas where plaque and bacteria tend to accumulate.⁵ By preventing gum inflammation and promoting a balanced oral microbiome, it offers an effective way to enhance oral health. “Oral health has always been important to me, and it’s incredible to see such tangible results,” Rebekka shares.

Olli Patrakka’s research supports the view that oral health should be a key consideration in stroke prevention as well. By recognizing the connection between oral bacteria and systemic inflammation, health-care providers can better manage stroke risk and potentially improve patient outcomes. Furthermore, timely antimicrobial treatments or the development of vaccines targeting harmful oral bacteria could offer additional strategies for stroke prevention.

Rebekka’s story highlights that taking care of oral health is not just about preventing cavities or gum disease—it’s a crucial part of overall well-being, including brain health. Her experience serves as a reminder that small changes in our daily health routines can have significant long-term effects. By recognizing the connection between oral and brain health, individuals can make informed decisions that may help reduce the risk of serious conditions in the future.

Editor’s note: This article first appeared in Clinical Insights newsletter, a publication of the Endeavor Business Media Dental Group. Read more articles and subscribe.

References

1. Woo HG, Chang YK, Lee JS, Song TJ. Association of periodontal disease with the occurrence of unruptured cerebral aneurysm among adults in Korea: a nationwide population-based cohort study. Medicina (Kaunas). 2021;57(9):910. doi:10.3390/medicina57090910
2. Leskelä J, Putaala J, Martinez-Majander N, et al. Periodontitis, dental procedures, and young-onset cryptogenic stroke. J Dent Res. 2024;103(5):494-501. doi:10.1177/00220345241232406
3. Patrakka O. Studies on the bacterial microbiome in thrombus aspirates of acute ischemic stroke patients. 2024. https://urn.fi/URN:ISBN:978-952-03-3315-7
4. Sen S, Giamberardino LD, Moss K, et al. Periodontal disease, regular dental care use, and incident ischemic stroke. Stroke. 2018;49(2):355-362. doi:10.1161/STROKEAHA.117.018990
5. Pakarinen S, Saarela RKT, Välimaa H, et al. Home-applied dual-light photodynamic therapy in the treatment of stable chronic periodontitis (HOPE-CP)—three-month interim results. Dent J (Basel). 2022;10(11):206. doi:10.3390/dj10110206
6. Nikinmaa S, Alapulli H, Auvinen P, et al. Dual-light photodynamic therapy administered daily provides a sustained antibacterial effect on biofilm and prevents Streptococcus mutans PLoS One. 2020;15(5):e0232775. doi:10.1371/journal.pone.0232775
7. Nikinmaa S, Moilanen N, Sorsa T, et al. Indocyanine green-assisted and LED-light-activated antibacterial photodynamic therapy reduces dental plaque. Dent J (Basel). 2021;9(5):52. doi:10.3390/dj9050052