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Study Shows Strong Ties Between Periodontal and Heart Health

Inflammation plays a key role in both periodontitis and atrial fibrosis.

Researchers at Japan’s Hiroshima University recently explored the connection between periodontitis and atrial fibrosis. Atrial fibrosis results in scarring of the heart’s left atrial appendages (LAA). This can lead to a common type of heart condition known as atrial fibrillation, or Afib.1

Afib often manifests as an abnormal or erratic heart rate, known as arrhythmia, and is reported to increase the risk for strokes, which can occur when blood flow to the brain is blocked by a blood clot or fatty deposit in the blood vessel lining. Credited with causing approximately one in seven strokes, Afib can reportedly increase the risk for ischemic strokes by five.2

Strokes caused by Afib complications are said to often be more severe than those with other causes. The United States Centers for Disease Control and Prevention estimates that 12.1 million Americans will have Afib in 2030.2


Lead author of the Japanese study, Shunsuke Miyauchi, PhD, is an assistant professor with Hiroshima University’s Health Service Center. He notes, “Periodontitis is associated with a long-standing inflammation, and inflammation plays a key role in atrial fibrosis progression and Afib pathogenesis. We hypothesized that periodontitis exacerbates atrial fibrosis.”3

To shed light on this relationship and to assess the degree of fibrosis, the researchers studied the left atrial appendages of 76 patients with Afib who had undergone LAA excision during cardiac surgery. Each subject underwent a pre-op oral examination, which noted the parameters for periodontal diseases as the remaining number of teeth, bleeding on probing, periodontal probing depth, and periodontal inflamed surface area.1


They did, indeed, find a link between periodontitis and Afib. All factors involved in periodontitis were found to correspond with Afib. There was an especially strong association between Afib and cases in which the periodontal surface area was inflamed.1

The research results point to the likelihood that periodontitis is a risk factor for Afib.1 Says study co-author, Yukiko Nakano, DDS, PhD, a professor of cardiovascular medicine in Hiroshima University’s Graduate School of Biomedical and Health Sciences, “This study provides basic evidence that periodontitis can aggravate atrial fibrosis and can be a novel modifiable risk factor for Afib.”3

Yet, Nakano cautions that while the evidence for a causal relationship is strong, it is not definitive. “Further evidence is required for establishing that periodontitis contributes to the Afib in a causal manner and that periodontal care can Afib,” she says, adding, “One of our goals is to confirm that periodontitis is a modifiable risk factor for Afib and to promote dental specialists’ participation in comprehensive Afib management. Periodontitis is an easy modifiable target with lower cost among known Afib risk factors. Thus, the achievement of this study series may bring benefits for many people worldwide.”3

The researchers said they hope to conduct future clinical trials to determine if periodontal intervention reduces Afib occurrence and improves patient outcomes.3


  1. Miyauchi S, Nishi H, Ouhara K, et al. Relationship between periodontitis and atrial fibrosis in atrial fibrillation. JACC Clin Electrophysiol. 2023;9:43.
  2. United States Centers for Disease Control and Prevention. Atrial Fibrillation.
  3. Science Daily. Gum Infection May Be a Risk Factor for Heart Arrhythmia, Researchers Find.
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