New Trial Finds Intensive Gum Treatment Slows Artery Thickening, May Lower Heart Risk

New Trial Finds Intensive Gum Treatment Slows Artery Thickening, May Lower Heart Risk

Originally published: November 2025 | Reviewed by Dr. Michael Berglass, DDS

Deck: A randomized trial from UCL found that treating severe gum disease reduced carotid artery wall thickening—an early marker of cardiovascular risk.

A new randomized clinical trial suggests that intensive treatment for severe gum disease may slow vascular aging — strengthening the biological link between oral health and cardiovascular disease — though direct evidence for fewer heart attacks or strokes remains to be proven.

Researchers at University College London (UCL) followed 135 adults diagnosed with periodontitis (gum disease affecting the supporting bone and tissue around the teeth) but who had no known chronic medical conditions. 

Participants were randomly assigned to receive either an intensive periodontal treatment—a full-mouth deep cleaning under local anaesthetic plus follow-ups—or a standard “scale and polish” routine dental cleaning. University College London

Over 24 months, the trial measured carotid intima-media thickness (cIMT)—a standard ultrasound measure of the combined thickness of the inner two layers of the carotid artery wall, often used as a surrogate marker of cardiovascular risk. PubMed.

Typical annual progression of carotid intima-media thickness (cIMT) in healthy adults is about 0.01–0.03 mm, so the 0.02 mm reduction seen here represents a meaningful change within that range.

Key finding: 

After two years, the intensive-treatment group had a 0.02 mm reduction in carotid artery wall thickening compared with the standard-care group. 

The authors note that each 0.01 mm decrease in cIMT has been linked in prior meta-analyses to roughly a 10 percent lower risk of cardiovascular events. 

The observed 0.02 mm reduction, therefore, falls within a clinically relevant range, though the trial did not track actual heart attacks or strokes.

The difference between groups reached statistical significance after adjustment for age, sex, and baseline inflammation, according to the study authors. University College London

“After 24 months, the participants who received the intensive gum-disease treatment had a 0.02 mm reduction in the thickening of their carotid arteries. … even a 0.01 mm reduction corresponds to a 10% decrease in cardiovascular disease risk.” 

Dr Marco Orlandi, UCL Co-Principal Investigator, University College London

The trial also measured additional vascular health markers—such as endothelial (blood-vessel lining) function, arterial stiffness, and inflammatory and oxidative-stress biomarkers—and found improvements in the intensive treatment arm. 

These findings support the biological theory that periodontal therapy may benefit cardiovascular health by lowering systemic inflammation and improving endothelial function. 

Participants receiving intensive therapy also showed favorable changes in inflammatory biomarkers, such as C-reactive protein (CRP), as well as in measures of oxidative stress. Live Science

Why it Matters

Chronic gum disease has increasingly been recognized as more than just a local oral issue. Because the gums are highly vascular and laden with bacteria, persistent gum inflammation can trigger systemic inflammation and disturb vascular health. 

The cIMT measure used in this trial is a well-studied marker: thicker carotid walls are associated with a greater risk of heart attacks and strokes.

By reducing oral-driven systemic inflammation, periodontal therapy may indirectly protect arterial walls from early atherosclerotic changes — an effect now measurable with vascular imaging. mdpi.com

“These findings offer compelling evidence that oral and systemic health are profoundly interconnected,” said Professor Francesco D’Aiuto, Co-Principal Investigator. “I believe there is a major opportunity for medical and dental professionals to collaborate more closely.” University College London

However, the authors and external experts caution that this is not conclusive proof that treating gum disease will directly lead to fewer heart attacks or strokes.

• The trial was conducted at a single site (UCL/Eastman Dental Institute) with a relatively modest sample size (N≈135) and healthy participants. That limits how broadly the findings apply. OUP Academic.
• The primary outcome was a surrogate marker (cIMT) rather than actual cardiovascular events (heart attacks, strokes, death). While cIMT is strongly associated with cardiovascular risk, the pathway from improved thickness to fewer events is indirect. Ovid 
• It remains to be seen whether the benefit holds in people with known cardiovascular disease, diabetes, or other health conditions, or whether the effect persists beyond two years.

Next Frontier:

 Future studies should test whether incorporating periodontal screening and treatment into standard cardiovascular-risk management — especially among people with diabetes or hypertension — can reduce real-world heart-attack and stroke rates. 

Such integration could also have major cost-effectiveness implications for preventive health policy.

Takeaway for Readers: 

While intensive gum treatment remains primarily a dental intervention, this study reinforces that consistent oral-health care — brushing, flossing, and timely periodontal therapy — may contribute to vascular health by curbing chronic inflammation at its source.

5 Steps to Keep Your Gums — and Heart — Healthy

1. Brush twice daily with a fluoride toothpaste.
2. Floss or use interdental brushes once per day.
3. Quit smoking — tobacco doubles gum disease risk.
4. Manage diabetes — high blood sugar fuels inflammation.
5. See your dentist every 6 months (or sooner if gums bleed/swell).

“Addressing periodontitis could become a powerful tool in preventing serious heart and brain events such as heart attacks and strokes.” — Professor John Deanfield, Chief Investigator of the trial, University College London.

Bottom line

The UCL trial, published in the European Heart Journal, finds that intensive periodontal treatment slowed carotid artery thickening by about 0.02 mm over 2 years—a change the researchers equate with roughly a 10% reduction in cardiovascular risk. 

While the findings are promising and biologically credible, larger multi-center trials that track real cardiovascular events are needed before clinicians can issue definitive “treat-gum-disease-to-prevent-heart-attack” guidance. 

For now, the UCL trial provides some of the strongest mechanistic evidence yet that oral health and vascular health are intimately connected.

Journal citation: Orlandi M, Masi S, Lucenteforte E et al. Periodontitis treatment and progression of carotid intima-media thickness: a randomized trial. Eur Heart J. 2025;doi:10.1093/eurheartj/ehaf555.