Clean your teeth to protect your heart

Brushing your teeth frequently is linked with lower risks of atrial fibrillation and heart failure, according to a study published in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC). Cleaning your teeth three times per day is understood to be the optimum frequency to help reduce the levels of harmful bacteria in the mouth, which can contribute to heart failure.

Previous studies have also made the link between poor oral hygiene and bacteria in the blood, causing inflammation in the body. Inflammation increases the risks of atrial fibrillation (irregular heartbeat) and heart failure (where the heart is unable to pump enough blood to meet the needs of the body).

The purpose of the study was to examine the potential links between oral hygiene and heart health. The National Institutes of Health, USA (NIH), recommend brushing your teeth at least twice a day to maintain healthy teeth and gums, but this researcher found that three times a day provides the greatest boost to your heart health.

The longitudinal study examined a total of 161,286 people aged 40 to 79 within South Korea's national health insurance system. None of the participants had a history of atrial fibrillation (irregular or abnormally fast heartbeats) or heart failure.

Participants were given a routine medical examination between 2003 and 2004. They collected information on height, weight, disease, lifestyle, oral health, and oral hygiene behaviours (e.g. frequency of teeth cleaning).

During the median follow up year, which was 10.5 years later - around 5% of participants had suffered heart failure and 3% developed atrial fibrillation. 

The researchers found that brushing teeth three or more times a day was associated with a 10% lower risk of atrial fibrillation, which refers to an abnormal heart rhythm characterised by rapid and irregular beating of the atrial chamber of the heart. They also found that this regular teeth cleaning ritual meant a 12% reduced risk of heart failure. These results were maintained after consolidating variable factors such as age, sex, socioeconomic status, regular exercise, alcohol consumption, body mass index, and incidiences of conditions such as such as high blood pressure.

Scientists believe that these results are due to the likely fact that regular teeth cleaning reduces the amount of bacteria (subgingival biofilms) that can reside between the teeth, gums and under the gums. Removing excess bacteria prevents it from entering the bloodstream.

This research was limited to an analysis of one country and as an observational study, it can not prove causality. More research is needed, but lead researcher Tae-Jin Song, of Ewha Womans University, Seoul, Korea explains: "we studied a large group over a long period of time, which adds strength to our findings." 

Other studies have shown that poor oral hygiene leads to bacteria in the blood, causing inflammation in the body, meaning Song’s team are strengthening the theory of the correlation between cleaning your teeth and good heart health. 

The researchers conclude: "It's certainly too early to recommend regular teeth cleaning for the direct prevention of atrial fibrillation and congestive heart failure.

"While the role of inflammation in the onset of heart disease is increasingly evident, intervention studies are needed to define strategies of public health importance”.

Reference: Chang Y, Woo HG, Park J, et al. Improved oral hygiene care is associated with decreased risk of occurrence for atrial fibrillation and heart failure: A nationwide population-based cohort study. Eur J Prev Cardiol. 2019. doi:10.1177/2047487319886018.

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