Dental Tribune Asia Pacific

Good oral hygiene may decrease risk of cardiovascular diseases

By Dental Tribune International
December 09, 2019

SEOUL, South Korea: Previous research has suggested that poor oral hygiene leads to bacteria in the blood, causing inflammation in the body. This increases the risks of atrial fibrillation and heart failure. A recent study, conducted by researchers from Ewha Womans University College of Medicine in Seoul, examined the connection between oral health status and the occurrence of these two conditions. They found that frequent toothbrushing was associated with a lower risk of heart disease.

The retrospective cohort study included 161,286 participants in the Korean National Health Insurance Service—Health Screening Cohort aged 40–79 with no history of atrial fibrillation or heart failure. Between 2003 and 2004, they underwent routine medical examinations, during which information on weight, illnesses, lifestyle, oral health and oral hygiene behaviour was collected and laboratory tests were done.

During a median follow-up of 10.5 years, 4,911 participants (3.0%) developed atrial fibrillation and 7,971 participants (4.9%) developed heart failure. Toothbrushing three or more times a day was associated with a lower risk of atrial fibrillation and heart failure. These findings were independent of a number of factors, including age, sex, socioeconomic status, regular exercise, alcohol consumption and body mass index, and independent of co-morbidities, such as hypertension.

While the study did not investigate mechanisms, one possible explanation for the findings is that frequent toothbrushing reduces bacteria in the subgingival biofilm, thereby preventing translocation to the bloodstream.

“Efforts to improve oral hygiene, including toothbrushing, will reduce the risk for atrial fibrillation and heart failure,” Dr Tae-Jin Song, assistant professor in the Department of Neurology at Mokdong Hospital at the university, told health news site Healio. “Therefore, the importance of taking good care of oral health can be reaffirmed through the results of this study.”

An accompanying editorial, titled “Does tooth brushing protect from atrial fibrillation and heart failure?”, stated: “It is certainly too early to recommend toothbrushing for the prevention of atrial fibrillation and congestive heart failure. While the role of inflammation in the occurrence of cardiovascular disease is becoming more and more evident, intervention studies are needed to define strategies of public health importance.”

The study, titled “Improved oral hygiene care is associated with decreased risk of occurrence for atrial fibrillation and heart failure: A nationwide population-based cohort study”, was published online on 1 December 2019 in the European Journal of Preventive Cardiology, ahead of inclusion in an issue.

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