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Fight Heart Disease with a Toothbrush

Neglecting your teeth may lead to heart disease.  This is according to a study published the latest issue of the British Medical Journal.
Researchers report that brushing your teeth less than twice a day can increase your risk of heart disease.

Researchers analyzed data from more than 11,000 people who participated in the Scottish Health Survey, in which individuals were asked about lifestyle behaviors such as smoking, physical activity, and oral health routines. Questions asked include how often they visited the dentist and how often they brushed their teeth.  This information was analyzed and compared with the participant’s medical history and family history of heart disease and blood pressure. Additionally, blood samples were taken from a subgroup of participants and tested for the inflammatory protein CRP and fibrinogen levels. The data gathered from the interviews were linked to hospital admissions and deaths.

The results showed that generally good oral hygiene practices, with 62% of participants saying they visited the dentist every six months and 71% reporting that they brushed their teeth twice a day.

Researchers analyzed the data and adjustment for established risk factors for heart disease which include age, sex, diabetes, smoking, physical activity, visits to dentist, body-mass index, family history of cardiovascular disease, hypertension, and socioeconomic group.

Researchers found that participants who reported less frequent toothbrushing had an increased risk of heart disease compared with people who brushed their teeth twice a day.  Researchers also found that participants who had poor oral hygiene also had increased levels of the CRP and fibrinogen blood tests.

The study authors comment that while it has been established that inflammation in the body (including mouth and gums) plays an important role in the buildup of atherosclerosis, this is the first study to investigate whether the number of times individuals brush their teeth has any bearing on the risk of developing heart disease.

The study authors also comment that “to the best of our knowledge, this is the first study to show an association between a single-item self-reported measure of toothbrushing and incident cardiovascular disease in a large representative sample of adults without overt cardiovascular disease.”   Additionally they add, “Our study suggests a possible role of poor oral hygiene in the risk of cardiovascular disease via systemic inflammation. Raised inflammatory responses as well as lipid metabolism disturbance caused by periodontal infection might be possible pathways underlying the observed association between periodontal disease and the increased risk for cardiovascular disease.”

The results of this study need to be further evaluated with additional studies to confirm whether the observed association between dental hygiene and cardiovascular disease is in fact causal or merely a risk marker.
Cristopher Geiler, MD

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