Valentine’s Day is just one day, but here in the Bear Cave we’re celebrating hearts all month long because February is American Heart Month!
They say the way to a man’s heart is through his stomach, but a growing body of research is explaining that you might not even need to go that far: another route to the heart is through the mouth (and, to be clear, this is true for both men and women).
The health of the oral microbiome is increasingly linked to cardiovascular disease through epidemiological studies and resesarch exploring the role of microbiome health in modulating the inflammatory mechanisms that underlie the development of cardiovascular disease. We’re going to keep it short and sweet today with a quick look at two recent studies that illustrate the important connection between dental habits and cardiovascular disease (CVD), and leave you with a few tips on how to support your oral microbiome and love your mouth this Valentine’s day. Enjoy!
Dental Habits and CVD
This January in the Journal of the American Dental Association, a population-based study using The National Health and Nutrition Examination Survey (NHANES) data from 2009-2016 and involving 18,801 adults found that flossing frequency was inversely associated with cardiovascular events and cardiovascular disease mortality1. Compared to not ever flossing, every additional day of flossing garnered a 5% reduction in cardiovascular events. Adults who flossed every day had a 29% lower chance of having a cardiovascular event compared to those who did not floss–now that is a substantial risk reduction!
This study additionally found that participants in the non-flossing group had significantly higher circulating levels of C-reactive protein, a marker of inflammation. This makes sense because inflammation is a key player in the development of atherosclerosis, the primary cause of cardiovascular disease. (When you see the word “inflammation,” think immune system activation, because that is what inflammation is.)
The second study we’ll touch on is a cohort-based study just published in the journal Stroke and involving 6,278 participants followed for 25 years. In this study, dental flossing was significantly associated with a 22% lower risk of ischemic stroke, a 44% lower risk of cardiembolic stroke, and a 12% lower risk of atrial fibrillation.
(Sidebar: Flossing was not signifcantly associated with a reduced risk of thrombotic or lacunar stroke. Note that these two types of stroke originate in the brain itself, whereas the other types of listed above originate in the periphery and are more common).
In the study, flossing at least once a week was considered “regular flossing,” so the bar was quite low there, and still the results are striking. Study authors note that regular flossers also had fewer cardiovascular disease risk factors, including hypertension and diabetes, than non-flossers.
Why is Flossing so Beneficial?
Flossing helps to disrupt biofilms, which are protective matrices that pathogenic bacteria can hide within. Disturbing these biofilms by flossing (and brushing) allows pathogenic bacteria to be swept away and gives the opporunity for beneficial bacteria to proliferate. A key point to keep in mind is that the bacteria in our mouths are not confined there. Pathogenic microbes originating in the oral cavity have been found throughout the body, such as in the brains of people with Alzheimer’s disease and in pancreatic tumors.3,4 When we have healthier microbial communities, we are better equipped to fend off insults to the immune system, such as pathogenic bacteria and viruses, and we have less systemic inflammation.
Flossing Tips*
- Floss once daily.
- Try a woven floss, sometimes called “expandable” or “expanding” floss. Brands I’ve used and liked are Radius and Thrive Market. This type of floss helps remove plaque and food particles much more effectively than typical waxed floss.
- Floss before brushing so you can rinse out the debris rather than swallow it.
Please share this with a loved one this Heart Month, or whenever!
*Disclaimer: This does not constitute medical advice and is for general informational purposes only. Please consult with your healthcare provider to determine whether diet, supplement, or lifestyle changes are right for you.
References
- Philip, N., Tamimi, F., Al-Sheebani, A., Almuzafar, A., & Shi, Z. (2025). The effect of self-reported flossing behavior on cardiovascular disease events and mortality: Findings from the 2009-2016 National Health and Nutrition Examination Surveys. Journal of the American Dental Association (1939), 156(1), 17–27.e3. https://doi.org/10.1016/j.adaj.2024.09.017https://pubmed.ncbi.nlm.nih.gov/39520447/
- https://www.ahajournals.org/doi/10.1161/str.56.suppl_1.19
- Herremans, K. M., Riner, A. N., Cameron, M. E., McKinley, K. L., Triplett, E. W., Hughes, S. J., & Trevino, J. G. (2022). The oral microbiome, pancreatic cancer and human diversity in the age of precision medicine. Microbiome, 10(1), 93. https://doi.org/10.1186/s40168-022-01262-7 https://pubmed.ncbi.nlm.nih.gov/35701831/
- Wan, J., & Fan, H. (2023). Oral Microbiome and Alzheimer’s Disease. Microorganisms, 11(10), 2550. https://doi.org/10.3390/microorganisms11102550 https://pubmed.ncbi.nlm.nih.gov/37894208/
Photo by S&B Vonlanthen on Unsplash