New research finds that brushing the teeth three or more times a day significantly reduces the risk of atrial fibrillation and heart failure.
The bacteria in our mouths may hold the key to many facets of our health.
Researchers have found intriguing clues about pancreatic and esophageal cancer risk in mouth bacteria, and some studies have linked poor oral hygiene with respiratory problems.
Mounting evidence is also strengthening the link between oral health and cardiovascular health.
For instance, some studies have found oral bacteria in the blood clots of people receiving emergency treatment for stroke, and experts have linked severe gum disease with a significantly higher risk of hypertension.
Conversely, destroying “friendly” oral bacteria that help maintain a healthy and balanced oral microbiome could disrupt blood pressure levels and also lead to hypertension.
The participants also underwent some laboratory tests, which included blood tests, urine tests, and blood pressure readings.
Brushing lowers heart failure risk by 12%
Over a median follow-up period of 10.5 years, 4,911 participants received a diagnosis of A-fib, and 7,971 developed heart failure.
Brushing the teeth three times or more a day was linked with a 10% lower chance of developing A-fib and a 12% lower risk of heart failure.
Confounding factors — including age, sex, socioeconomic status, physical activity, alcohol intake, body mass index, and other coexisting conditions, such as hypertension — did not influence these results, as the researchers accounted for them in their analysis.
The authors conclude:
“Improved oral hygiene care was associated with decreased risk of atrial fibrillation and heart failure. Healthier oral hygiene by frequent toothbrushing and professional dental cleanings may reduce risk of atrial fibrillation and heart failure.”
However, they also note that, as with any observational study, the research is limited and cannot explain causation. The study is also limited because it only looked at people living in one country, so the results may not be generalizable.
Nonetheless, notes the study’s senior author, “We studied a large group over a long period, which adds strength to our findings.”
Study strengths and limitations
In an accompanying editorial, authors Pascal Meyre, from the Cardiovascular Research Institute at the Basel University Hospital in Switzerland, and David Conen, from the Population Health Research Institute, McMaster University, Canada, offer a critical look at the findings.
They agree that the strengths of the study “are the large sample size, with over 160,000 individuals included in the study, the large number of outcome events, and the long follow-up duration.”
“This allowed the investigators to carry out meaningful analyses and adjust the multivariable models for many covariates, such that some of the confounding could be controlled,” they add.
However, the retrospective design of the study “may have introduced selection bias,” say the authors of the editorial. Furthermore, the participants’ “level of education, marital status, and information on inflammatory biomarkers, such as C-reactive protein, were not available.”
The information on toothbrushing and oral hygiene habits was self-reported, which might subject it to recall bias, write Meyre and Conen.
“The causality of these associations is unclear, and it is certainly too early to recommend toothbrushing for the prevention of [A-fib] and [congestive heart failure],” they conclude:
“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.”
(Medical News Today)
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