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A recent preliminary study suggests that habitual flossing may correlate with a reduced risk of stroke associated with blood clots that impede blood flow to the brain, as well as irregular heart rhythms. The findings will be shared at the upcoming American Stroke Association’s International Stroke Conference 2025, set to take place in Los Angeles from February 5 to 7, 2025, which serves as a major gathering for experts in stroke and brain health.
Study leader Souvik Sen, M.D., M.S., M.P.H., who chairs the Department of Neurology at Prisma Health Richland Hospital and the University of South Carolina School of Medicine in Columbia, noted that a worldwide health report indicated that oral health issues—like neglected cavities and gum disease—impacted around 3.5 billion people in 2022, marking them as the most prevalent health problems globally. “Our focus was on identifying the oral hygiene practice—whether it’s flossing, brushing, or visiting the dentist regularly—that plays the most significant role in preventing strokes,” he stated.
The research utilized data from the Atherosclerosis Risk in Communities (ARIC) study, a significant U.S. investigation assessing dental floss use through structured interviews with over 6,000 participants. Among the individuals who indicated they flossed, 4,092 reported no history of stroke, and 4,050 were free of atrial fibrillation (AFib), a type of irregular heartbeat.
Respondents provided information regarding various health metrics, including high blood pressure, diabetes, cholesterol levels, smoking habits, body mass index, educational background, and frequency of brushing and dental visits. Over a follow-up period of 25 years, 434 participants were identified as having suffered strokes, categorized into 147 stemming from larger artery clots, 97 from cardiac sources, and 95 related to smaller artery hardening. A total of 1,291 cases of AFib were also documented.
The analysis revealed several key findings:
- Flossing was linked to a 22% decrease in the risk of ischemic stroke.
- The risk of cardioembolic stroke was reduced by 44% among regular flossers.
- There was a 12% lower risk of developing AFib associated with flossing.
- This risk reduction appeared independent of the frequencies of brushing and dental check-ups.
- Increased flossing frequency was associated with greater reductions in stroke risk.
- Additionally, flossing seemed to correlate with lower instances of cavities and gum disease.
Researchers expressed particular interest in the noted decrease in AFib occurrences, as this condition is the most prevalent type of irregular heartbeat, which can escalate the risk of stroke, heart failure, and additional cardiovascular complications. The American Heart Association projects that by 2030, over 12 million people in the U.S. may experience AFib.
Sen concluded, “Oral health is closely related to inflammation and the hardening of arteries. Flossing may mitigate stroke risk by reducing oral infections and inflammation while promoting other healthy lifestyle choices. Since many perceive dental care as expensive, flossing presents an easily adoptable, affordable, and accessible healthy practice.”
Despite the promising findings, the study does have limitations, including its reliance on self-reported questionnaire data and the lack of continuous monitoring of flossing habits or other oral health practices throughout the follow-up period.
“This research contributes valuable insights into the dental health behaviors potentially linked to stroke risk reduction. Should further studies substantiate these findings, integrating dental health practices into the ‘Life’s Essential 8’ risk factors—which encompass diet, exercise, smoking, sleep habits, body weight, blood pressure, blood glucose, and lipids—could be highly beneficial,” remarked Daniel T. Lackland, Dr.P.H., FAHA, a member of the American Heart Association’s EPI and Stroke Council, who was not involved in the study.
Study details include:
- The research commenced in 1987 and continues to evolve.
- Among the 6,258 participants, 82% identified as white and 18% as Black, with an average age of 62 and 55% being women.
- Individuals were excluded if they had significant tooth loss, dental implants, pre-existing heart conditions, organ transplants, artificial joints, implanted heart valves or stents, or major surgeries.
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