December 02, 2019
2 min read

Good oral hygiene may lower risk for HF, AF

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Patients with improved oral hygiene had a lower risk for atrial fibrillation and HF compared with those with poor oral hygiene, according to a study published in the European Journal of Preventive Cardiology.

“Efforts to improve oral hygiene, including tooth brushing, will reduce the risk for atrial fibrillation and heart failure,” Tae-Jin Song, MD, PhD, assistant professor in the department of neurology at Mokdong Hospital at Ewha Womans University College of Medicine in Seoul, South Korea, told Healio. “Therefore, the importance of taking good care of oral health can be reaffirmed through the results of this study.”

Yoonkyung Chang, of the department of neurology at Mokdong Hospital at Ewha Womans University College of Medicine, and colleagues analyzed data from 161,286 patients (mean age, 52 years; 61% men) from the National Health Insurance Service-National Health Screening Cohort in South Korea who were free from HF, AF or cardiac valvular diseases. Information obtained from the system included weight, height, lifestyle questionnaires, laboratory tests, oral health disease and oral hygiene behaviors.

A questionnaire was also conducted to learn more about dental visits in the past year, dental systems and oral hygiene behavior. Dentists examined the patients for teeth condition and the presence of periodontal disease.

Of the patients in the cohort, 3% developed AF and 4.9% developed HF during a median follow-up of 10.5 years.

Patients who frequently brushed their teeth — three or more times a day — had a lower risk for HF (HR = 0.88; 95% CI, 0.82-0.94; P for trend < .001) and AF (HR = 0.9; 95% CI, 0.83-0.98; P for trend = .011) after adjusting for factors such as sex, age, socioeconomic status, BMI, diabetes and hypertension.

Professional dental cleaning weakened the risk for HF (HR = 0.93; 95% CI, 0.88-0.99), whereas the risk for HF increased when patients were missing at least 22 of their teeth (HR = 1.32; 95% CI, 1.11-1.56; P for trend = .002).


“Our study has limitations [including] Asian population-based study and a retrospective cohort study,” Song said in an interview. “Further prospective multiethnic study should be performed.”

In a related editorial, Pascal Meyre, MD, of the Cardiovascular Research Institute Basel at University Hospital Basel in Switzerland, and David Conen, MD, MPH, associate professor in the division of cardiology at McMaster University in Hamilton, Ontario, wrote: “The causality of these associations is unclear, and it is certainly too early to recommend tooth brushing for the prevention of AF and congestive HF. 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.” – by Darlene Dobkowski

For more information:

Tae- Jin Song, MD, PhD, can be reached at Department of Neurology, Mokdong Hospital, Ewha Womans University College of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Korea; email:

Disclosures: The authors of the study and the editorial report no relevant financial disclosures.