Poor oral health in childhood may predict a higher risk of atherosclerotic cardiovascular disease (ASCVD) later in life, according to a nationwide cohort study from Denmark that followed more than half a million individuals from childhood into adulthood.
Researchers analyzed oral health records from 568,778 people born between 1963 and 1972 and linked them with national hospital data tracking cardiovascular outcomes through 2018. Children with more severe dental caries or gingivitis were more likely to develop ASCVD as adults, including ischemic heart disease, myocardial infarction, and ischemic stroke.
The findings – published in the International Journal of Cardiology – highlight oral health as a potential early-life marker for cardiovascular risk. Individuals with severe childhood dental caries had a higher incidence of ASCVD compared with those with minimal disease, and elevated gingivitis scores were also associated with increased risk.
Importantly, the pattern of oral disease over time appeared to matter as much as its presence. Participants whose dental disease persisted or worsened across childhood showed a greater likelihood of cardiovascular events in adulthood than those with consistently low disease levels.
Studies suggest oral disease may reflect systemic processes, such as chronic inflammation or microbial dissemination, that contribute to vascular pathology. Oral bacteria and inflammatory mediators originating from periodontal disease have previously been detected in atherosclerotic plaques, suggesting a possible biological pathway linking oral and cardiovascular health.
Although this study does not establish causality, it supports the concept that early-life exposures can shape long-term cardiometabolic risk profiles. Because dental caries and gingivitis are among the most common diseases in children worldwide, even modest associations could translate into substantial population-level impacts.
Researcher Merete Markvart, from the University of Copenhagen, said, “In Denmark, 20 percent of children and young people account for 80 percent of all registered dental disease. If we can identify markers indicating who is at higher risk of various diseases later in life, we can tailor preventive efforts to those groups. And that could have long-term health benefits well into adulthood.”
The authors note that further studies incorporating lifestyle data and adult oral health measures are needed to clarify mechanisms and determine whether improving childhood oral health can reduce long-term cardiovascular risk.
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