Periodontal Health can Improve the Prognosis of Cardiovascular Disease

Flossing at least once a week may be associated with a lower risk of stroke, caused by a blood clot blocking cerebral blood flow and with cardiac arrhythmias, according to a preliminary American study. Presented in February 2025 in Los Angeles at the American Stroke Association meeting, the study [1] adds to the growing body of evidence linking oral health to systemic health. This study, led by Prof. Souvik Sen, director of the University of South Carolina School of Medicine in Columbus (SC), aimed to assess whether good oral hygiene habits (brushing, flossing, and regular dental check-ups) have an impact on stroke prevention. This large-scale research evaluated the regular use of dental floss at home through a structured questionnaire administered to 6,000 people. Among the data collected from patients were various parameters, including hypertension, cholesterol levels, smoking habits, BMI, education level, brushing frequency, and frequency of dental check-ups. Over a 25-year follow-up period, 434 stroke cases were recorded, with a different distribution across stroke subtypes and artery sizes. Additionally, 1291 participants developed atrial fibrillation during the study. In this analysis, flossing was associated with a 22% reduction in the risk of ischemic stroke, a 44% lower risk of cardioembolic stroke, and a 12% reduction in the risk of atrial fibrillation. Other variables analyzed (brushing frequency, regular dental visits, or other oral hygiene techniques) did not show statistically significant correlations. Moreover, there was a significant decrease in atrial fibrillation events, the most common form of cardiac arrhythmia. Atrial fibrillation is a strong cardiovascular (CV) health modifier because it increases the risk of stroke, heart failure, and other peripheric cardiovascular complications. Dr. Sen concluded that flossing might reduce stroke risk by significantly limiting inflammation and infections, demonstrating the strong connection between oral health, inflammation, and atherosclerosis. The study also highlighted the same positive effects of hygiene therapy, previously described, in preventing cavities and periodontal disease (PD). According to the Global Health Observatory (World Health Organization) in 2024, approximately 45% of the global population was affected by hypertension, with prevalence increasing with age. Both diastolic and systolic blood pressure values are closely correlated with the risk of cardiovascular mortality and all-cause mortality, making hypertension the leading cause of death in the modern population [2]. A recent literature review and meta-analysis [3] on the effectiveness of blood pressure reduction in preventing cardiovascular events and mortality suggests that lowering blood pressure is beneficial, as evidenced by the numerous studies included in the meta-analysis. Hypertension causes multi-organ damage, irreversibly impairing the function of various body systems, including the eyes, kidneys, microcirculation, brain, and all cardiovascular system (leading to multiple heart diseases and arterial damages in medium and large blood vessels).