CLAIM:
Bleeding gums are not just a dental issue but can increase the risk of heart disease and diabetes due to long-term inflammation and bacterial spread through the bloodstream.
FACT:
Bleeding gums, a sign of periodontal disease, are linked to poorer blood sugar control in diabetes and a higher risk of heart disease and stroke. However, studies show an association rather than direct causation, with experts noting that shared risk factors like smoking, poor diet, and obesity play a major role. Maintaining good oral hygiene and regular dental check-ups is important.
In a viral Instagram reel posted by fitness coach and influencer Priyank Mehta, who has around 10 lakh followers, a familiar health concern is framed as a serious warning sign. The reel, which has garnered over 1.05 lakh views and 401 shares, is presented as a conversation between Mehta and a woman, using a bitten apple smeared with blood to symbolise bleeding gums.
The woman shows the apple and appears alarmed. Mehta responds, “Don’t take bleeding gums lightly. It increases the risk of heart disease and diabetes.” When she dismisses the claim as “nonsense,” Mehta explains that bleeding gums are a sign of gingivitis, which he describes as long-term inflammation.
According to him, when inflammation persists, “the bacteria go into the bloodstream” and can reach the arteries, where it deposits and contribute to plaque formation, increasing the risk of heart disease. The woman reacts with shock, prompting Mehta to further link gum disease with diabetes, stating that inflamed gums interfere with insulin action, keeping blood sugar levels high. He adds that diabetes, in turn, increases the risk of gum disease threefold, creating what he calls a “vicious cycle.”
Towards the end of the reel, the conversation shifts to a sponsor. Mehta introduces a Pepsodent toothpaste, claiming it works not just on teeth but also on gums. Referring to its “advanced zinc formula,” he says it reduces inflammation, controls gum bleeding, and reduces plaque.
Are bleeding gums linked to heart disease and diabetes?
Several studies suggest that bleeding gums are linked to diabetes complications and may be associated with heart disease and stroke, though a direct causal link has not been proven.
According to Harvard Health Publishing, people with periodontal disease are about twice as likely to experience a heart attack compared with those who have healthy gums, although shared risk factors such as smoking, an unhealthy diet, or limited access to health and dental care may contribute to this association.
However, some bacterial and viral infections also appear to increase the risk of heart attack and stroke. “The bacteria responsible for periodontal disease can travel to blood vessels throughout the body,” Harvard Health notes, adding that periodontal bacteria have been found in fatty deposits that clog arteries and even in blood clots from people who have suffered heart attacks.
“In both gum disease and heart disease, we find bacteria in places where they're not supposed to be,” explains Dr Jiang. The immune system’s response to these misplaced bacteria triggers inflammation, which may contribute to clot formation and increase the risk of heart attack or stroke. However, Harvard Health also stresses that while treating gum disease can reduce inflammatory markers in the blood, there is limited evidence that it directly lowers the risk of heart attacks or other cardiovascular events.
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A study titled ‘Periodontitis and diabetes: a two-way relationship’ describes periodontitis as a chronic inflammatory condition affecting up to 10–15 per cent of adults in its severe form. Epidemiological data from the study show that people with diabetes are about three times more likely to develop periodontitis, and that higher blood sugar levels are associated with more severe gum disease.
The study notes that inflammation from periodontitis can, in turn, worsen glycaemic control. “There is emerging evidence to support the existence of a two-way relationship between diabetes and periodontitis,” the authors write, adding that periodontal treatment has been associated with modest reductions in HbA1c levels—a blood test measuring your average blood sugar (glucose) over the past 2-3 months. The study concludes that oral and periodontal health should be considered an integral part of diabetes management.
Another study published in the American Journal of Preventive Medicine analysed health and dental insurance records of nearly 339,000 individuals diagnosed with periodontal disease along with one of five conditions, including type 2 diabetes, cardiovascular disease, cerebrovascular disease (such as stroke), rheumatoid arthritis, or pregnancy. The researchers found that, except in cases of rheumatoid arthritis, people who received at least one treatment for periodontal disease had lower medical costs and fewer hospitalisations within four years compared to those who did not receive treatment. Among individuals with cardiovascular or cerebrovascular disease, healthcare costs were 10 to 40 per cent lower following periodontal treatment, suggesting that managing gum disease may be associated with improved overall health outcomes and reduced healthcare burden, though the study does not establish a direct causal relationship.
One Indian study examining 207 patients with type 2 diabetes and chronic periodontitis found that individuals with higher levels of gum inflammation had significantly poorer glycaemic control. Participants with greater periodontal inflamed surface area (PISA) showed higher average blood sugar levels and were more likely to have complications such as retinopathy and nephropathy. Even after adjusting for age, BMI, socioeconomic status and duration of diabetes, periodontal inflammation remained a significant predictor of elevated blood sugar levels.
However, not all studies support a direct causal link between oral health and heart disease. A large 2018 Korean cohort study involving nearly one million participants found that while tooth loss was associated with coronary heart disease in the general population, this link disappeared in men who had never smoked. The authors concluded that, at least in men, the relationship between poor oral health and heart disease appeared to be largely explained by confounding factors such as cigarette smoking, raising questions about a direct causal connection.
In fact, a recent 2025 study published in Neurology revealed that people suffering from both gum inflammation and dental cavities face an 86 per cent higher risk of ischaemic stroke—the most common kind of stroke caused by the blockage of a blood vessel— compared to those with healthy mouths. However, they also cautioned that factors such as socioeconomic status, diet, genetics, and access to healthcare could influence outcomes, and therefore, more longitudinal studies are needed before establishing a direct cause-and-effect relationship.
Another 2025 cross-sectional study from South India examined shared risk factors for periodontal disease, diabetes and cardiovascular disease. The researchers found that age, obesity, poor oral hygiene, HbA1c levels, triglycerides and lifestyle factors were common risk markers across these conditions. The study concluded that “integrating these factors into surveillance tools may enhance non-communicable disease (NCD) and periodontal disease (PD) risk identification, supporting a Common Risk Factor Approach (CRFA)–based healthcare approach.”
What experts say
Commenting on the link between oral health and stroke, Dr Viswanathan Iyer, Neurosurgeon at Zynova Shalby Hospital, Mumbai, told First Check earlier that India faces significant challenges regarding oral hygiene. He observed that habits such as betel nut chewing and poor dental care make oral health a widespread issue in the country. “While dental cavities and gum health can contribute to overall health, they are not the primary focus when assessing stroke risk.”
Dr Iyer emphasised that in India, stronger risk factors like hypertension, diabetes, obesity, tobacco use, smoking, sedentary lifestyle, and poor diet play a much larger role in stroke occurrence. "Good oral hygiene is certainly important, not only for preventing dental issues but also as a preventative measure for other diseases such as heart disease and oral cancers. Conditions like oral submucous fibrosis, often caused by betel nut chewing, can make mouth opening difficult and are known precursors to oral cancer."
Adding to this, Dr Anand S, Specialist in Oral Medicine and Radiology at MIDAC Dental Centre, Kozhikode, explained that claims linking gum inflammation to heart disease through bacterial spread are biologically plausible but not definitive. “Bacterial migration and systemic inflammation are real phenomena, and some studies support this idea,” he said, “but heart disease is multifactorial and cannot be attributed to oral health alone.”
Turning to diabetes, Dr Anand explained that high blood sugar can impair white blood cell function, weakening the body’s ability to fight infections and making people with diabetes more susceptible to gum disease. According to him, individuals with diabetes are three to four times more likely to develop periodontal disease.
However, he cautioned against reversing this relationship. “It is much more common to see diabetes leading to gum disease than gum disease causing diabetes,” he noted, adding that the idea of gum disease directly causing diabetes remains unproven.
Dr Anand acknowledged that several studies have reported associations between periodontal disease, diabetes, and other complications, but stresses that a clear causal link has not yet been established. “There is no strong evidence to say gum disease directly causes diabetes. We definitely need more long-term studies to confirm that,” he said.
Drawing from his clinical experience, Dr Anand observed that a large proportion of patients with periodontal disease also have diabetes. “When I see patients with advanced gum disease, one of the first questions we ask is whether they have diabetes. Around 60–70 per cent of them say yes,” he said, adding, “So there is a clear association, but association does not mean causation.”
Emphasising prevention, Dr Anand advised regular dental check-ups as the most effective way to maintain gum health. “A routine dental examination every 10 to 12 months is essential,” he said. “Maintaining good oral hygiene and keeping the oral cavity clean can go a long way in preventing gum disease and its possible systemic effects.”
This story is done in collaboration with First Check, which is the health journalism vertical of DataLEADS.