Improved oral hygiene care is associated with decreased risk of occurrence for atrial fibrillation and heart failure: A nationwide population-based cohort study

Abstract

Aims Poor oral hygiene can provoke transient bacteremia and systemic inflammation, a mediator of atrial fibrillation and heart failure. This study aims to investigate association of oral hygiene indicators with atrial fibrillation and heart failure risk in Korea. Methods We included 161,286 subjects from the National Health Insurance System-Health Screening Cohort who had no missing data for demographics, past history, or laboratory findings. They had no history of atrial fibrillation, heart failure, or cardiac valvular diseases. For oral hygiene indicators, presence of periodontal disease, number of tooth brushings, any reasons of dental visit, professional dental cleaning, and number of missing teeth were investigated. Results During median follow-up of 10.5 years, 4911 (3.0%) cases of atrial fibrillation and 7971 (4.9%) cases of heart failure occurred. 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 (≥3 times/day) was significantly associated with attenuated risk of atrial fibrillation (hazard ratio: 0.90, 95% confidence interval (0.83–0.98)) and heart failure (0.88, (0.82–0.94)). Professional dental cleaning was negatively (0.93, (0.88–0.99)), while number of missing teeth ≥22 was positively (1.32, (1.11–1.56)) associated with risk of heart failure. Conclusion 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.

Large Gender Gap in Oral Hygiene Behavior and Its Impact on Gingival Health in Late Adolescence

“…Systemic health condition is affected by oral hygiene level. For example, improved oral hygiene behavior is associated with decreased risk of atrial fibrillation and heart failure [29]. Periodontal therapy provides good systemic effects in patients with type 2 diabetes [22].…”

Oral health and gastrointestinal cancer: A nationwide cohort study

“…Deaths, cause of death and emigrations are linked to the national statistical office/national administrator's comprehensive and computerized databases using resident registration identification numbers. Thus, deaths, cause of death and emigrations can be accurately identified (Chang, Woo, Park, Lee, & Song, 2019; Park et al., 2019).…”

Oral health and changes in lipid profile: A nationwide cohort study

“…Professional dental scaling was categorized into 'no' or 'yes' based on the individual's self-reported answer to the question 'Have you received professional dental scaling in the last year?' from the survey data (Chang et al, 2019). In a self-questionnaire, the frequency of tooth brushing was subgrouped into ≤1 time/, 2 times/day and ≥3 times/day.…”

“…Moreover, the behaviours and indicators of oral hygiene include tooth brushing, dental scaling, missing teeth and dental caries (Chang et al, 2013;Guha et al, 2007). Periodontitis, an indicator of oral hygiene, is associated with hypertension, diabetes mellitus (DM), atrial fibrillation, heart failure and long-term mortality (Chang et al, 2019Martin-Cabezas et al, 2016;Park et al, 2019). There is emerging evidence regarding significant interplay between lipid metabolism and systemic or local inflammation/infection (Samra et al, 1996).…”