Mind and Body

Brushing your teeth this many times per day could save your life

Good oral hygiene means more than fresh breath and zero cavities. 

Endai Huedl/ Getty Images

For most people, brushing their teeth is a daily routine (often practiced while half-asleep) designed to keep teeth clean and breath minty fresh. Brushing your teeth and flossing (there’s a reason your dentist goes on about it) prevents gingivitis, gum disease, and tooth decay. But if that’s not enough to inspire you to get serious about oral health, the practice also has more serious, far-reaching benefits. In fact, a new study suggests that brushing your teeth three times a day could save your life.

That’s because brushing your teeth keeps inflammation-causing bacteria in your mouth in check — and the same bacteria can threaten an organ that’s far from the mouth: the heart.

The study was published in the European Journal of Preventive Cardiology.

The tooth-heart connection

To understand how tooth brushing affects heart health, researchers studied over 160,000 participants of the Korean National Health Insurance System between ages 40 to 79. The participants had no prior history of common heart problems like irregular heartbeats, or heart failure.

In 2003, the researchers performed an exam on participants and collected an array of health data, including their height, weight, illnesses, and oral health practices.

Ten and a half years later, they checked back on the participants’ health. Out of the total study population, three percent of participants developed atrial fibrillation and 4.9 percent developed heart failure in the decade after the original exam. But they also discovered something stunning among the data: Tooth brushing three or more times a day was associated with a 10 percent lower risk of atrial fibrillation and a 12 percent lower risk of heart failure.

The results held even when other potential heart health factors like exercise, alcohol consumption, or body mass index were taken into account.

Stopping inflammation’s insidious spread

The way it works is this: Brushing your teeth helps protect the heart by cutting down on the amount of bacteria entering your bloodstream. Bacteria in the blood can trigger inflammation throughout the body, which in turn increases the risks of heart problems like irregular heart beat and heart attacks.

If you don't brush, bacteria can build up, especially in the gums. That bacteria can wreak havoc on rest of the body, causing system-wide harm.

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The findings don’t mean poor oral hygiene causes heart problems, however.

“It is certainly too early to recommend tooth brushing for the prevention of atrial fibrillation and congestive heart failure,” Tae-Jin Song, researcher at Ewha Womans University in Seoul, Korea and senior author of the study, said. “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.”

Brushing your teeth isn’t a surefire replacement for other known heart health strategies. Taking regular exercise, quitting smoking, and managing stress can all benefit. But protecting the heart adds to the long list of good reasons to keep up with your daily hygiene routine.

For those that already follow their clinicians’ advice, the study finding lines up with current clinical guidelines. The American Dental Association recommends brushing 2-3 times per day (especially after meals), replacing toothbrushes every three months, getting your teeth professionally cleaned, and flossing on a daily (or at least weekly!) basis.

Your mouth — and heart — will thank you.

Aims: Poor oral hygiene can provoke transient bacteremia and systemic inflammation, a mediator of atrial fibrillation and heart failure. This study aims to investigate association of oral hygiene indicators with atrial fibrillation and heart failure risk in Korea.
Methods: We included 161,286 subjects from the National Health Insurance System-Health Screening Cohort who had no missing data for demographics, past history, or laboratory findings. They had no history of atrial fibrillation, heart failure, or cardiac valvular diseases. For oral hygiene indicators, presence of periodontal disease, number of tooth brushings, any reasons of dental visit, professional dental cleaning, and number of missing teeth were investigated.
Results: During median follow-up of 10.5 years, 4911 (3.0%) cases of atrial fibrillation and 7971 (4.9%) cases of heart failure occurred. In multivariate analysis after adjusting age, sex, socioeconomic status, regular exercise, alcohol consumption, body mass index, hypertension, diabetes, dyslipidemia, current smoking, renal disease, history of cancer, systolic blood pressure, blood and urine laboratory findings, frequent tooth brushing (≥3 times/day) was significantly associated with attenuated risk of atrial fibrillation (hazard ratio: 0.90, 95% confidence interval (0.83–0.98)) and heart failure (0.88, (0.82–0.94)). Professional dental cleaning was negatively (0.93, (0.88–0.99)), while number of missing teeth ≥22 was positively (1.32, (1.11–1.56)) associated with risk of heart failure.
Conclusion: Improved oral hygiene care was associated with decreased risk of atrial fibrillation and heart failure. Healthier oral hygiene by frequent tooth brushing and professional dental cleaning may reduce risk of atrial fibrillation and heart failure.
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