Brushing teeth three or more times a day shown to reduce risk of heart failure

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Heart failure is a condition where the heart is unable to pump enough blood around the body, if this happens it usually means the heart is too stiff or too weak. A chronic condition, heart failure is one which has to be managed over time to prevent the heart deteriorating. However, what is preferable to is to prevent heart failure from developing in the first place. One of the ways to do this is through brushing your teeth regularly according to a study conducted by the Ewha Womans’ University College of Medicine in Seoul in 2019.

The researchers found that the risk of heart failure could be reduced if someone brushed their teeth three or more times a day. Publishing their work in the European Journal of Preventive Cardiology, they wrote: “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 was significantly associated with attenuated risk of atrial fibrillation.”

Furthermore, they concluded: “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.”

As a result, their study suggested that cardiovascular health could be dramatically impacted by poor or positive oral health.

As to why frequent tooth brushing helped reduce the risk of heart failure, the team suggested it was to do with how teeth brushing reduces inflammation: “Poor oral hygiene can provoke transient bacteremia and systemic inflammation, a mediator of atrial fibrillation and heart failure.”

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How did they reach their result?

The team reached their conclusion after studying data from 161,286 people who took part in the Korean National Health Insurance System-Health Screening Cohort. The participants in the study were between the ages of 40 and 79 years old and had no history of heart failure.

As well as being asked about their medical history, those in the study also submitted to a selection of laboratory tests where their blood and urine were both tested as well as blood pressure readings taken regularly.

Overall, it was found that those who brushed their teeth regularly, three or more times a day, reduced their risk of heart failure by 12 percent. Meanwhile, the risk of atrial fibrillation – also known as an irregular heartbeat – found their risk was reduced by 10 percent.

While the study was observational rather than causational, and so could not conclude a link between the two, it was helped by its sample size which “allowed the investigators to carry out meaningful analyses and adjust the multivariable models for many covariates, such that some of the confounding could be controlled” said the authors.

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On the other hand, one of the limitations of the study was its observational nature and the retrospective design of the study which the authors said “may have introduced selection bias” according to the authors.

Furthermore, they also wrote: “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.”

They added: “The causality of these associations is unclear, and it is certainly too early to recommend toothbrushing for the prevention of [A-fib] and [congestive heart failure],” they conclude.”

As a result, they agreed that more studies were required in order to draw a link between regular teeth brushing and heart failure.

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Nevertheless, should a causational study find a link between the two, it would mark a new pathway for people to prevent the development of a condition which causes distress to all those with the condition.

Symptoms of heart failure include:
• Breathlessness
• Fatigue
• Swollen ankles and legs
• Feeling lightheaded and fainting.

Although these are the most common symptoms, less common signs can also arise:
• A persistent cough
• Wheezing
• A bloated tummy
• Loss of appetite
• Weight gain
• Weight loss
• Confusion
• A fast heart rate
• Heart palpitations.

Furthermore, the NHS added that some patients with heart failure “may also experience feelings of depression and anxiety” and suggest seeking medical advice if the symptoms persist or get worse.

In common with other cardiovascular conditions, heart failure is a long-term condition which has to be managed to prevent deterioration. The main treatments traditionally include healthy lifestyle changes, medication, devices implanted into the body, and surgery.

Lifestyle changes often recommended include regular exercise and moving to a balanced diet alongside the potential taking of medications.

These medications include those which are often used to treat other forms of heart disease such as high blood pressure.

All of this will form part of a heart failure care plan, one unique to each patient with heart failure.

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