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Stroke and Oral Health

A stroke can weaken one side of the body, affect swallowing and dry the mouth, which makes mouth care both harder and more important. Here is what can help in hospital and at home.

Updated September 2026·By the OHA editorial team·7 min read·How we write
Key takeaways
  • A stroke can cause arm weakness, swallowing problems and changes to the mouth muscles, making it harder to clean your teeth and wear dentures (Stroke Association).
  • If swallowing is affected, bacteria from the mouth can be breathed into the lungs and cause pneumonia. NICE says good mouth care lowers this risk.
  • NICE advises brushing teeth and gums at least twice a day after a stroke, with an electric brush if needed, and help from a trained person, family member or carer for anyone who cannot manage.
  • Gum disease is linked to stroke in studies, but it has not been shown to cause stroke.
  • Signs of a stroke are an emergency: call 999 (UK), triple zero 000 (Australia) or 911 (US).

The NHS describes a stroke as blood stopping flowing to part of the brain, which can affect speech and movement. The Stroke Association says effects such as arm weakness, swallowing difficulties or problems with thinking and memory can make it harder to look after your mouth, and that you should have help if you need it.

Get help urgently
  • UK: the NHS uses FAST: Face (one side may droop), Arms (you may not be able to lift both), Speech (slurred or confused), Time to call 999. Call 999 even if the signs stopped within the last 24 hours, and do not drive yourself to A&E.
  • Australia: healthdirect also uses FAST (face or mouth drooping, not lifting both arms, slurred speech). Call triple zero (000) straight away and ask for an ambulance.
  • US: the American Stroke Association uses B.E. F.A.S.T., adding sudden Balance loss and Eye (vision) changes. Call 911 immediately.
  • Chest infection: the Stroke Association says pneumonia is more likely after a stroke, and to call 999 if someone is struggling to breathe, or has chest pain or a rapid heartbeat.

How can a stroke affect your mouth?

The Stroke Association says mouth and dental problems may be more common after a stroke. It lists complications of swallowing problems, including lung infections; a bad taste from a fungal infection (oral thrush); tooth decay and gum infections, which make the mouth sore; and difficulty wearing dentures.

Weakness on one side

Weakness in one arm or hand can make it hard to hold a toothbrush. If your face or lip muscles are affected, the Stroke Association says saliva may escape from your mouth. For one-handed ways to apply toothpaste and easier-to-hold brushes, see cleaning your teeth when gripping is hard. If someone helps you, see caring for someone else's teeth.

Food left in the mouth

Newcastle Hospitals NHS Foundation Trust lists pocketing, meaning food left on the tongue or in the mouth, among the signs of swallowing problems. The Stroke Association lists food or drink left in the mouth after swallowing, and the American Stroke Association lists food getting stuck in the mouth. What can help:

  • Check and clear the mouth. The Newcastle trust suggests making sure the tongue, cheeks and roof of the mouth are clean and clear, using a toothbrush if needed, and that dentures are secure before and after eating.
  • Chew on the stronger side if one side of your face or mouth is weaker (MedlinePlus, US National Library of Medicine).

The Stroke Association says traces of food left in the mouth can lead to gum infections or tooth decay.

Swallowing problems and chest infections

The Stroke Association says swallowing problems are very common after a stroke. If food, drink or even saliva goes into the airway, this is called aspiration, and because the mouth contains many bacteria it can lead to pneumonia. The American Stroke Association adds that a stroke can reduce sensation, so you may not cough when this happens (silent aspiration).

The Stroke Association says everyone who has a stroke should have their swallowing assessed within four hours of arriving at hospital, and should not swallow food, drink or medicine until it has been checked. It says most people can swallow safely again within the first few weeks. NICE says people with swallowing problems after a stroke should be supported to follow an effective mouth care routine, because this decreases the risk of aspiration pneumonia (a chest infection caused by breathing something into the lungs).

Dry mouth and dentures

The Stroke Association says changes to the mouth muscles, or a dry mouth, can make dentures harder to wear. For a dry mouth caused by swallowing problems or medicines, it suggests asking your GP or speech and language therapist: even if you cannot drink, saliva sprays or gels may help. See dry mouth and dentures.

Mouth care in hospital

NICE's guideline on stroke rehabilitation in adults (NG236, England) recommends that:

  • oral hygiene is assessed using national or local protocols
  • people are encouraged, at least twice a day, to brush their teeth and gums, using an electric or battery-powered toothbrush if needed, and to use mouthwash and oral gels with antibacterial and antifungal properties if needed
  • a suitably trained healthcare professional, family member or carer gives or supervises mouth care for anyone who cannot manage it.

NICE's committee said the studies it reviewed varied, but all showed fewer deaths with a standard mouth care routine than with usual care, and some found fewer cases of pneumonia.

If you have swallowing problems, the Stroke Association says to ask your stroke nurse or speech and language therapist for individual advice about keeping your mouth clean. They should show you and your family or carer the safest way to clean your teeth, tongue and mouth before you go home.

Mouth care at home

The Stroke Association suggests:

  • Brush after meals if you can, or at least twice a day for about two minutes, including before bed.
  • Use a pea-sized amount of fluoride toothpaste with at least 1,350 or 1,450 ppm (parts per million) fluoride. Spit out, but do not rinse.
  • Consider a non-foaming toothpaste free of sodium lauryl sulphate (SLS) if you have swallowing problems: it says this may be easier and help reduce the risk of aspiration.
  • Clean your tongue and the inside of your mouth gently with a soft brush.
  • Take dentures out at night, clean them regularly and keep them in a labelled container.
  • Limit sugary food and drinks. Food supplements can also cause decay, so clean your teeth or rinse with water after them.

If gripping a brush is hard, it says an occupational therapist can advise on adaptations.

Dental visits after a stroke

The Stroke Association advises regular dental check-ups, and asking about home visits if you cannot travel to the surgery. Tell your dentist about your stroke and every medicine you take. healthdirect says a doctor may prescribe aspirin or other blood thinners after a stroke caused by a clot; if you take one, see blood thinners and dental treatment.

Does gum disease cause stroke?

It has not been shown to. healthdirect says there is growing evidence that poor oral health is linked to stroke, heart disease and other conditions. The American Heart Association's 2025 scientific statement says studies support an association between gum disease and events including stroke, and that shared risk factors such as age, smoking and obesity contribute, but that causality has not been established.

A 2022 Cochrane review (a systematic review of trials) looked for evidence that treating gum disease prevents events such as stroke or heart attack. It found only two small, unreliable studies and could not draw conclusions. Gum disease is still worth treating for your teeth and gums; see also heart disease and oral health.

Where to get support

  • UK: the Stroke Association's Stroke Support Helpline, 0303 3033 100 (Monday to Friday 9am to 5pm, Saturday 10am to 1pm).
  • Australia: healthdirect lists StrokeLine, 1800 787 653. The healthdirect helpline, 1800 022 222, is available at any time.
  • US: the American Stroke Association's Stroke Family Warmline, 1-888-4-STROKE (1-888-478-7653), 8:30am to 5pm Central Time, Monday to Friday.
When to see a dentist
  • Brushing or cleaning your dentures has become hard since your stroke.
  • Your dentures no longer feel secure or comfortable.
  • Your gums bleed when you brush, or are painful and swollen (NHS).
  • You have a bad taste in your mouth, which the Stroke Association says can come from thrush.
  • You take a blood thinner and need dental treatment.

Frequently asked questions

Why does mouth care matter so much after a stroke?

If swallowing is affected, bacteria from the mouth can be breathed into the lungs and cause pneumonia (Stroke Association). NICE says an effective mouth care routine lowers the risk of aspiration pneumonia.

Can I take ibuprofen for toothache after a stroke?

Check first. The NHS says ibuprofen may not be suitable if you have had a stroke, and to ask a pharmacist or doctor if you are not sure. See toothache.

Will treating my gum disease lower my risk of another stroke?

This has not been shown. The American Heart Association says trials are still needed, and a 2022 Cochrane review found no reliable evidence either way.

Sources

  1. Stroke, NHS, accessed September 2026
  2. Symptoms of a stroke, NHS, accessed September 2026
  3. Gum disease, NHS, accessed September 2026
  4. Ibuprofen for adults, NHS, accessed September 2026
  5. Stroke rehabilitation in adults (NG236): recommendations, National Institute for Health and Care Excellence, accessed September 2026
  6. Stroke rehabilitation in adults (NG236): rationale and impact, National Institute for Health and Care Excellence, accessed September 2026
  7. Looking after your mouth and teeth (oral hygiene), Stroke Association, accessed September 2026
  8. Swallowing problems, Stroke Association, accessed September 2026
  9. Stroke Support Helpline, Stroke Association, accessed September 2026
  10. Eating and drinking difficulties (dysphagia), Newcastle Hospitals NHS Foundation Trust, accessed September 2026
  11. Stroke, healthdirect Australia, accessed September 2026
  12. Gum disease, healthdirect Australia, accessed September 2026
  13. Stroke symptoms, American Stroke Association, accessed September 2026
  14. Trouble swallowing after stroke (dysphagia), American Stroke Association, accessed September 2026
  15. Stroke Family Warmline, American Stroke Association, accessed September 2026
  16. Swallowing problems, MedlinePlus (US National Library of Medicine), accessed September 2026
  17. Top things to know: periodontal disease and atherosclerotic cardiovascular disease, American Heart Association (summary of its 2025 scientific statement), accessed September 2026
  18. Treating chronic gum inflammation (periodontitis) to prevent heart and blood vessel (cardiovascular) disease, Cochrane (Ye and others, 2022), accessed September 2026

This article is general information about oral health. It is not a diagnosis or a substitute for advice from a dentist or doctor who knows your situation. If you have pain, swelling, bleeding that does not settle, or a problem that is getting worse, see a dental professional. In an emergency, contact your local emergency service.

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