People who don’t brush their teeth twice a day have a higher risk of developing heart disease, according to research based on Scottish data.
Those who do not brush their teeth as often have a 70 per cent extra risk of heart disease than those who brushed them twice a day, although the overall risk remained quite low, researchers say.
The findings could mean that asking people how often they brush their teeth could help doctors determine who is at risk of future cardiovascular disease, the researchers say.
It has already been established that inflammation in the body, including the mouth and gums, plays an important role in the build up of clogged arteries and, over the last two decades, there has been increased interest in links between heart problems and gum disease.
But this research, published on bmj.com, is the first to investigate whether the number of times that people brush their teeth has any bearing on the risk of developing heart disease, the authors say.
The study, led by Professor Richard Watt from University College London, analyzed information from more than 11,000 adults who took part in the Scottish Health Survey.
The data analyzed covered lifestyle behaviors, such as smoking, exercise and oral health routines.
Oral health was generally good, with around 62 per cent of participants reporting regular (at least every six months) visits to the dentist, and 71 per cent reporting good oral hygiene (brushing teeth twice a day).
Participants who brushed their teeth less often were slightly older, more likely to be men and of lower socioeconomic status, and had a high prevalence of risk factors, including smoking, physical inactivity, obesity, hypertension and diabetes.
On a separate visit, nurses collected information on medical history and family history of heart disease, blood pressure and blood samples – these enabled the researchers to determine the levels of inflammation present in the body.
The information gathered from the interviews was then linked to hospital admissions and deaths in Scotland until December 2007.
Once the data were adjusted to take into account other risk factors for heart disease, such as family history, social class, obesity and smoking, the researchers found that participants who reported less frequent tooth-brushing had a 70 per cent extra risk of heart disease compared to those who brushed their teeth twice per day.
People who had poor oral hygiene also tested positively for inflammatory “markers” in the body such as C-reactive protein and fibrinogen.
Prof Watt said that more work would need to be done to confirm whether poor oral health was a marker for cardiovascular disease, or whether it actually caused it. But he said: “Our results confirmed and further strengthened the suggested association between oral hygiene and the risk of cardiovascular disease – furthermore inflammatory markers were significantly associated with a very simple measure of poor oral health behavior.”
But he says that a “simple self-report measure of tooth-brushing” could give a good idea of a person’s future risk of cardiovascular disease.
“Given the high prevalence of oral infections in the population, doctors should be alert to the possible oral source of an increased inflammatory burden.
“In addition, educating patients in improving personal oral hygiene is beneficial to their oral health regardless of the relation with systemic disease.”