Skipping daily brushing can increase your risk of cardiovascular disease

In a recent study published in Scientific reportsresearchers looked at whether brushing frequency increases the risk of cardiovascular disease (CVD) in patients 20 years of age or older.

Research: Not brushing your teeth at night may increase your risk of cardiovascular disease.  Image credit: Ground Picture / Shtuterstock.comResearch: Not brushing your teeth at night can increase your risk of cardiovascular disease. Image credit: Ground Picture /


Several previous studies have emphasized the importance of perioperative oral care and management in patients with malignant cancer, as well as respiratory, gastrointestinal, and cardiovascular diseases.

Many of these reports focus on brushing time in relation to tooth demineralization. However, these reports did not examine the relationship between brushing time and systemic diseases, including CVD.

About research

Subjects included in this study were hospitalized at Osaka University Hospital in Japan between April 2013 and March 2016 for investigation, surgery, or treatment. The analysis also included patients who visited the hospital’s dental department for dental treatment, perioperative oral care, and infection screening.

A total of 1,675 study participants were divided into four groups. The MN group reported brushing twice a day, once upon waking and again at night, while the Night group reported brushing only once at night. The M group reported brushing their teeth only after waking up, while the None group did not brush their teeth.

The number of participants in each group was 409, 751, 164 and 259, respectively. The number of men in the M group was four times greater than the number of women in this group.

The Night and MN groups had the highest percentages of subjects reporting brushing their teeth after lunch, 44.9% and 24%, respectively. Few of the study participants, M and None, reported brushing their teeth after lunch.

The researchers assessed each participant’s age, sex, smoking history, and follow-up results. In addition, four independent investigators retrospectively reviewed the dental and medical records of all study participants.

Oral health, pre-hospitalization frequency and time of brushing, depth of periodontal pockets, degree of tooth mobility and number of teeth were studied by one dentist.

The study looked at several cardiovascular events, which included CVD-related hospitalizations for heart failure, arrhythmia, myocardial infarction, angina, and valvular and aortic disease requiring surgery.

A proportional hazards model was used to estimate the association between observations and the occurrence of cardiovascular events and lifetime prognosis. For subgroup analysis stratified by smoking status, Kaplan-Meier curves were used to estimate the time from the participants’ dental visit to the study end point of death or the end of the study period. All statistical analyzes were reviewed P-values ‚Äč‚Äčless than 0.05 as significant.

Research findings

All participants had similar levels of C-reactive protein (CRP), hemoglobin, albumin, creatinine, and HbA1c, but different levels of brain natriuretic peptide (BNP), based on blood samples obtained at hospital admission. The MN and Night groups had significantly higher survival rates compared to the None group.

All study participants had similar smoking status; however, they had different dental parameters. For example, the MN group had the most participants with dental pocket depths greater than eight millimeters (mm). Compared to the Night and M groups, more patients in the None and MN groups had a tooth mobility index of three.

In their clinical practice, researchers encountered many middle-aged and older people who did not brush their teeth at night. In their interviews, many of these patients mentioned that they drank alcohol at night, which resulted in them being too tired and not brushing their teeth.

In each study group, several individuals reported not brushing their teeth at night. This may be due to habits learned from parents during childhood, lifestyle and regional differences. General lack of interest in dental hygiene is another reason why people do not brush their teeth at night and after lunch.

Breakfast and lunch have been shown to increase the risk of intraoral deposits that remain in the mouth throughout the day, resulting in an increased risk of dental caries and other periodontal diseases. Thus, brushing teeth only in the morning after waking up is insufficient and means poor oral hygiene. Additionally, brushing at night is critical to maintaining good oral health, which supports the hypothesis that intraoral bacterial load increases during sleep due to decreased salivary flow.


The results of the study reiterate that while brushing your teeth before breakfast is necessary, brushing your teeth at night before bed is even more important for preventing cardiovascular disease.

Journal reference:

  • Isomura, ET, Suna, S., Kurakami, H. and others. (2023). Not brushing your teeth at night can increase your risk of cardiovascular disease. Scientific reports 13(10467). doi:10.1038/s41598-023-37738-1

#Skipping #daily #brushing #increase #risk #cardiovascular #disease

Leave a Comment