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Dr Sandlin of Sandlin DDS | Discusses Oral Health and Heart Disease

Dr. James Sandlin - Tuesday, January 13, 2015

More News on Oral Health and Heart Disease

I came across an article on MedScape, a news service for health professionals. It's authored by Sue Hughes from the UK. Bottom line, the healthier your mouth, the less likely you are to have heart problems. Brush your teeth less than once a day and you're twice as likely to have heart problems!


Ms Hughes' article cited a recent study published online in the British Medical Journal by Prof Richard Watt of University College London, UK. Prof Watt and his group noted that inflammation in the body (including mouth and gums) plays an important role in the buildup of atherosclerosis. The study investigated whether the number of times individuals brushes their teeth influences their risk for heart disease.


The article stated that researchers looked at over 11,000 adults. Individuals were asked about lifestyle choices such as smoking, physical activity, and their oral health habits. They were also asked how often they visited the dentist and how often they brushed their teeth. Medical history and family history of heart disease and blood pressure were then factored in. Blood samples were analyzed from some participants and levels of C-reactive protein (CRP) and fibrinogen were determined. The data gathered from the interviews was then linked to hospitalizations and death.


(C-reactive protein is an indirect measurement of inflammation in your body, and fibrinogen is a building block for blood clots. Levels of both chemicals rise with your degree of inflammation.)


The study found generally good oral hygiene habits, with 62% of participants visiting the dentist every six months and 71% reporting that they brushed their teeth twice a day. After risk factors were accounted for, participants who brushed their teeth less than twice a day were found to have an increased risk of heart disease. Those who had poor oral hygiene had increased levels of CRP and fibrinogen.


Here are some of the research findings:


Hazard Ratio for Cardiovascular Events (Fatal and Nonfatal) Relative to How Often Teeth Are Brushed Each Day

Frequency of tooth brushing      HR* (95% CI)

Twice a day 1.0

Once a day 1.3 (1.0–1.5)

Less than once a day 1.7 (1.3–2.3)

p for trend 0.001


*Adjusted for age, sex, socioeconomic group, smoking, physical activity, visits to dentist, body-mass index, family history of cardiovascular disease, hypertension, and diabetes


The researchers think that this is the first study linking toothbrushing and the rate of heart problems in adults who do not already have cardiovascular disease.


They feel this study suggests the role of poor oral hygiene in the risk of cardiovascular disease by raising systemic inflammation. Inflammation and clotting activity could be an underlying cause of periodontal disease and create an increased risk for heart disease.


More research is needed, but a body of evidence is pointing to oral health being a major factor in your overall health.




de Oliveira C, Watt R, and Hamer M. Toothbrushing, inflammation, and risk of cardiovascular disease: Results from Scottish Health Survey. BMJ 2010; DOI:10.1136/bmj.c2451. Available at:


Dr Sandlin | Sandlin DDS Lawrenceville, Ga

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