AHA scientific statement on gum disease and atherosclerotic cardiovascular disease (2026): an independent association, not a proven cause, and no proof yet that periodontal treatment prevents heart disease

What it says#

The statement, titled Periodontal Disease and Atherosclerotic Cardiovascular Disease: A Scientific Statement From the American Heart Association, was published online in Circulation on December 16, 2025 and appears in the February 10, 2026 print issue. It updates the AHA's 2012 statement on the same question. It was prepared by a volunteer writing group chaired by Andrew H. Tran, MD, MPH, MS, a pediatric cardiologist at Nationwide Children's Hospital in Columbus, Ohio, with Abbas H. Zaidi, MD, as vice chair, on behalf of the Cardiovascular Disease Prevention Committee of the Council on Lifelong Congenital Heart Disease and Heart Health in the Young and four other AHA councils. Two dentists are on the author list, Rashmi Hegde, BDS, MS, and Lauren L. Patton, DDS.

The abstract frames the job: since 2012 the literature has grown substantially, atherosclerotic cardiovascular disease is the leading cause of death globally, and the statement synthesizes new evidence on an association between periodontal disease and ASCVD, including findings from Mendelian randomization studies, interventions targeting periodontal disease, and studies of systemic markers such as inflammatory cytokines and vascular measures. It also highlights disparities in the prevalence of periodontal disease, particularly among underresourced populations, explores potential mechanisms through direct pathways such as bacteremia and indirect pathways such as chronic systemic inflammation, and identifies areas that need further research.

The AHA news release lists the highlights. Periodontal disease is a chronic inflammatory condition affecting over 40% of US adults over age 30, running from gingivitis to periodontitis to severe periodontitis with damage to the bone supporting the teeth. It is more common in people with poor oral hygiene and with other cardiovascular risk factors, such as high blood pressure, overweight or obesity, diabetes and smoking, and its prevalence is higher among men, older adults, people with low physical activity and people affected by adverse social determinants of health, such as lower socioeconomic status, food insecurity and lack of access to health care including dental care.

On the link itself the release is precise. Although periodontal disease and ASCVD share common risk factors, emerging data indicate there is an independent association between the two conditions. Numerous studies have found periodontal disease associated with an increased risk of heart attack, stroke, atrial fibrillation, heart failure, peripheral artery disease, chronic kidney disease and cardiac death. Then the limit: although periodontal disease clearly contributes to chronic inflammation that is associated with ASCVD, a cause-and-effect relationship has not been confirmed.

On treatment the release is equally careful. There is no direct evidence that periodontal treatment will help prevent cardiovascular disease. Treatments that reduce lifetime exposure to inflammation appear to be beneficial in reducing the risk of developing ASCVD, and the treatment and control of periodontal disease and its associated inflammation may contribute to the prevention and improved management of ASCVD. People with one or more cardiovascular risk factors are considered at higher risk and may benefit from regular dental screenings and targeted periodontal care to address chronic inflammation. The release cites previous studies in which more frequent tooth brushing was associated with lower 10-year ASCVD risk, 13.7% for brushing once daily or less against 7.35% for three or more times a day, and with reduced inflammatory markers. More research, including long-term studies and randomized controlled trials, is needed to determine whether periodontal treatment can affect ASCVD progression and outcomes, and the role of socioeconomic status and access to dental care should be explored.

Dr. Tran's summary in the release: "Your mouth and your heart are connected," and "Gum disease and poor oral hygiene can allow bacteria to enter the bloodstream, causing inflammation that may damage blood vessels and increase the risk of heart disease."

Who it applies to#

The statement is written for clinicians and researchers in cardiology and dentistry, and it describes adults with periodontal disease of any stage. For a dental practice its reach is the conversation: what a hygienist or dentist may say to a patient, and to a referring physician, about what gum disease means for the heart. The release's own audience line is that people with one or more cardiovascular risk factors may benefit from regular dental screenings and targeted periodontal care.

What it does not do is prescribe. The AHA notes that scientific statements inform the development of guidelines but do not make treatment recommendations; the AHA's guidelines carry its official clinical practice recommendations. Nothing in the statement tells a dentist to treat periodontitis in order to prevent a heart attack, and the release says there is no direct evidence that doing so works.

What changed#

The 2012 statement, from a writing group chaired by Peter B. Lockhart, concluded that observational studies to date supported an association between periodontal disease and atherosclerotic vascular disease independent of known confounders but did not support a causative relationship, and that although periodontal interventions reduced systemic inflammation and endothelial dysfunction in short-term studies, there was no evidence that they prevented ASVD or modified its outcomes. It also warned that patients and providers were being presented with claims that periodontal treatment offers cardiovascular protection, often endorsed by professional and industrial stakeholders.

Fourteen years later the association is described as supported by more and different kinds of evidence, including Mendelian randomization, and the release's list of associated outcomes now runs to atrial fibrillation, heart failure and chronic kidney disease alongside heart attack and stroke. The two limits did not move: causation is unconfirmed and treatment has not been shown to prevent disease. What is new in emphasis is the disparity finding and the release's suggestion that people with cardiovascular risk factors may benefit from regular dental screening and targeted periodontal care.

Where the source is#

The statement is in Circulation, volume 153, issue 6, pages e73-e88, DOI 10.1161/CIR.0000000000001390; the link under the title opens the article page on the AHA journals site. The AHA newsroom release of December 16, 2025 carries the plain-language highlights, the writing group and the AHA's note that statements do not make treatment recommendations. When this entry was written, the journal page and the AHA's professional "Top Things to Know" page refused automated access, so the entry was built from the abstract as indexed on PubMed and from the news release; numbers that appear only inside the full text are not reported here. The 2012 statement is on PubMed with its abstract.