Brushing teeth 3-4 times a day lowers risk of atrial fibrillation, heart failure, says ESC Study

Oral Hygiene may indeed be a major contributor to heart health. Tooth brushing three or more times a day was associated with a 10% lower risk of atrial fibrillation and a 12% lower risk of heart failure a major 10.5-year follow up study has revealed. The study has been published in the European Journal of Preventive Cardiology.

According to this study, brushing teeth frequently is linked with lower risks of atrial fibrillation and heart failure.

Oral infections frequently lead to chronic inflammation, such as gingivitis, periodontitis, and endodontic lesions. Inflammation may be a risk factor for atrial fibrillation (AF)and heart failure. Previous research suggests that poor oral hygiene leads to bacteria in the blood, causing inflammation in the body. This study examined the connection between oral hygiene and the occurrence of these two conditions.

The retrospective cohort study enrolled 161,286 participants of the Korean National Health Insurance System aged 40 to 79 with no history of atrial fibrillation or heart failure. Participants underwent a routine medical examination between 2003 and 2004. Information was collected on height, weight, laboratory tests, illnesses, lifestyle, oral health, and oral hygiene behaviours.

During a median follow-up of 10.5 years, 4,911 (3.0%) participants developed atrial fibrillation and 7,971 (4.9%) developed heart failure.

Tooth brushing three or more times a day was associated with a 10% lower risk of atrial fibrillation and a 12% lower risk of heart failure during 10.5-year follow up. The findings were independent of a number of factors including age, sex, socioeconomic status, regular exercise, alcohol consumption, body mass index, and comorbidities such as hypertension.

While the study did not investigate mechanisms, one possibility is that frequent tooth brushing reduces bacteria in the subgingival biofilm (bacteria living in the pocket between the teeth and gums), thereby preventing translocation to the bloodstream.

Senior author Dr Tae-Jin Song of Ewha Woman's University, Seoul, Korea noted that the analysis was limited to one country and as an observational study does not prove causation. But he added: "We studied a large group over a long period, which adds strength to our findings."

An accompanying editorial states: "It is certainly too early to recommend toothbrushing for the prevention of atrial fibrillation and congestive heart failure". It adds: "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."

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