People who brush their teeth twice a day have a significantly lower risk of heart disease compared to individuals who have poor oral hygiene, says a report published in the British Medical Journal (BMJ) today.

Over the last couple of decades there has been a growing interest in the link between heart and gum disease. While it has been agreed that inflammation in the body (including mouth and gums) plays an important role in the accumulation of clogged arteries, this is the first study to examine whether the number of times individuals brush their teeth has any impact on the risk of developing heart disease, says the researchers.

Lead author, Professor Richard Watt from University College London, and team analyzed data from over 11,000 adults who took part in the Scottish Healthy Survey.

The team looked at information regarding the adults' lifestyle behaviors, such as physical activity, oral health routines and smoking. People were asked how regularly they went to the dentist's - once every six months, two years, rarely, or never. They were also asked how often their brushed their teeth - twice, once, or fewer times per day.

On a separate visit nurses gathered information on medical and family history of heart disease, blood pressure and blood samples from consenting adults. The samples helped the researchers to determine levels of inflammation that were present in the body. The data gathered from the interviews were linked to hospital admissions and deaths in Scotland until December 2007.

The results showed that oral health behaviors were generally good, with 62% of participants saying they visit the dentist every six months, and 71% reporting that they brush their teeth twice a daily. Once the data were adjusted for established cardio risk factors such as social class, obesity, smoking and family history of heart disease, the authors found that individuals who reported less frequent toothbrushing had a 70% higher risk of heart disease compared to individuals who brushed their teeth twice a day, although the overall risk remained quite low. Participants who had poor oral hygiene also tested positive for inflammatory markers such as the C-reactive protein and fibrinogen. Professor Watt concluded:

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. Future experimental studies will be needed to confirm whether the observed association between oral health behaviour and cardio vascular disease is in fact causal or merely a risk marker.

Research paper
"Toothbrushing, inflammation, and risk of cardio vascular disease - results from the Scottish Health Survey"
Published 27 May 2010, doi:10.1136/bmj.c2451
BMJ 2010;340:c2451