Maintaining optimal oral hygiene has long been recognized as essential for dental health. However, emerging research indicates that practices such as regular flossing may also play a significant role in reducing the risk of cardiovascular events, including stroke and atrial fibrillation (AFib). This article delves into recent findings that highlight the connection between flossing and heart health, exploring the underlying mechanisms and broader implications for cardiovascular disease prevention.
A study presented at the American Stroke Association’s International Stroke Conference 2025 examined data from over 6,000 adults with an average age of 62, monitored for up to 25 years as part of the Atherosclerosis Risk in Communities (ARIC) study. The researchers discovered that individuals who flossed at least once per week experienced a 22% reduction in the risk of ischemic stroke, a 44% reduction in cardioembolic stroke, and a 12% reduction in the risk of AFib. Moreover, increased frequency of flossing correlated with even greater risk reductions.
Dr. Souvik Sen, the study's lead author and chair of the Department of Neurology at Prisma Health Richland Hospital and the University of South Carolina School of Medicine, emphasized the significance of these findings:
“Oral health behaviors are linked to inflammation and artery hardening. Flossing may reduce stroke risk by lowering oral infections and inflammation and encouraging other healthy habits. Many people have expressed that dental care is costly. Flossing is a healthy habit that is easy to adopt, affordable, and accessible everywhere.”
The association between oral health and cardiovascular disease has been the subject of extensive research. Periodontal disease (PD), a chronic inflammatory condition affecting the gums and supporting structures of the teeth, has been linked to an increased risk of major adverse cardiovascular events (MACEs), including coronary heart disease, myocardial infarction (heart attack), stroke, cardiac death, and all-cause mortality. pmc.ncbi.nlm.nih.gov
A comprehensive meta-analysis encompassing over 4 million individuals found that PD was associated with a heightened risk of these cardiovascular outcomes. The proposed mechanisms include the entry of periodontal pathogens into the bloodstream, leading to direct invasion of cardiovascular tissues and contributing to atherosclerosis—the buildup of fatty deposits in arteries. pmc.ncbi.nlm.nih.gov
Furthermore, research indicates that individuals with gum disease are two to three times more likely to experience a heart attack, stroke, or other serious cardiovascular events compared to those with healthy gums. Shared risk factors, such as smoking and poor diet, may partially explain this association. However, there is a growing suspicion that gum disease may be an independent risk factor for heart disease. health.harvard.edu
The connection between oral health and cardiovascular disease is believed to be mediated by systemic inflammation. Chronic inflammation from periodontal disease can lead to the release of inflammatory markers into the bloodstream, contributing to the development and progression of atherosclerosis. Additionally, bacteria from infected gums can enter the circulatory system, directly affecting the cardiovascular system. amjmed.com
Regular flossing helps remove plaque and food particles from areas between the teeth that a toothbrush cannot reach, thereby reducing the risk of gum disease and subsequent inflammation. By maintaining healthy gums, individuals may lower the systemic inflammatory burden, potentially decreasing the risk of cardiovascular events.
The findings from the ARIC study and other research underscore the importance of oral hygiene as a potentially modifiable risk factor for cardiovascular disease. Incorporating regular flossing into daily routines is a simple, cost-effective measure that may contribute to cardiovascular health.
Dr. Daniel T. Lackland, a member of the American Heart Association's EPI and Stroke Council, noted:
“This study offers more insights into the specific dental health behaviors that may be linked to stroke risks and potential risk reduction. With further research, dental health practices could possibly be incorporated into the 'Life's Essential 8' risk factors, which include diet, physical activity, nicotine exposure, sleep, body mass index, blood pressure, blood glucose, and blood lipids.”
While more research is needed to establish a causal relationship between flossing and reduced cardiovascular risk, current evidence suggests a compelling association. Regular flossing may serve as a valuable tool in the prevention of stroke and AFib by mitigating oral inflammation and its systemic effects. Healthcare providers should consider emphasizing the importance of oral hygiene in cardiovascular risk assessments and patient education.
Cardiovascular Business (2025). Regular flossing reduces risk of stroke, AFib. Retrieved from: Cardiovascular Business
American Stroke Association (2025). Regular dental flossing may lower risk of stroke from blood clots, irregular heartbeats. Retrieved from: Heart.org
Atherosclerosis Risk in Communities (ARIC) Study (2025). Long-term cardiovascular impact of periodontal health. Retrieved from: National Heart, Lung, and Blood Institute (NHLBI)
Harvard Health Publishing (2024). Gum disease and heart disease: The common thread. Retrieved from: Harvard Health
National Institutes of Health (NIH) (2024). Periodontal disease and major adverse cardiovascular events: A systematic review. Retrieved from: PubMed Central
The American Journal of Medicine (2024). Oral health, systemic inflammation, and cardiovascular risk. Retrieved from: The American Journal of Medicine
