Regular use of dental floss lowers the risk of stroke and arrhythmias.

The conference taking place this year in Los Angeles is the premier global gathering of researchers and clinicians focused on stroke science and brain health.

A recent report on global health indicated that in 2022, oral diseases—such as untreated cavities and gum diseases—will affect 3.5 billion people, making them the most prevalent health issues. "Our research team aimed to determine which oral hygiene practice—flossing, brushing, or regular dental visits—has the most significant impact on stroke prevention," explains lead researcher Souvik Sen, MD, chair of the neurology department at Prisma Health Richland and the University of South Carolina School of Medicine in Columbia, South Carolina.

The Atherosclerosis Risk in Communities (ARIC) study, one of the first large-scale studies of its kind in the U.S., evaluated at-home flossing habits through structured surveys of over 6,000 individuals. Among those who reported using dental floss, 4,092 had not experienced a stroke, and 4,050 had not been diagnosed with arrhythmia.

Participants were asked about their health, including issues like high blood pressure, diabetes, high cholesterol, smoking, body mass index, education, and the regularity of their tooth brushing and dental visits. Over 25 years of observation, 434 participants were identified as having strokes, of which 147 were linked to clots in the major arteries of the brain, 97 had clots in the heart, and 95 showed hardening of small arteries.

The analysis revealed:

• Flossing reduced the risk of ischemic stroke by 22%, the risk of cardioembolic stroke (clots forming in the heart) by 44%, and the risk of developing atrial fibrillation by 12%.
• This risk reduction was independent of tooth brushing frequency, dental visits, or other oral hygiene practices.
• Increased frequency of flossing was associated with a greater likelihood of reduced stroke risk.
• Flossing was also linked to a lower likelihood of developing cavities and periodontal diseases.

Researchers were surprised by the reduction in the incidence of arrhythmias and atrial fibrillation (AF). AF is the most common form of irregular heartbeat and can lead to stroke, heart failure, and other cardiovascular complications. According to projections from the American Heart Association, by 2030, over 12 million people in the U.S. will be affected by AF.

"Oral hygiene behavior is linked to inflammation and arterial hardening. Flossing may reduce stroke risk by decreasing infections and inflammation in the mouth and fostering other healthy habits," says Sen. "Many people believe that dental care is expensive. Flossing is a healthy habit that is easy to adopt, cost-effective, and always accessible."

Study history and details:

• The study began in 1987 and continues to this day.
• Of the 6,258 participants, 82% were adults of Caucasian descent, and 18% were African American. The average age of participants was 62, with 55% being women.
• Individuals with complete tooth loss, dental implants, heart disease, organ transplants, artificial joints, implanted heart valves, or stents, as well as those who had undergone major surgeries, were excluded from the study.