Poor Tooth Brushing Behavior Is Associated with High Risk of Cardiovascular Events

Background: Poor oral care is associated with cardiovascular disease. The aim of this study was to determine the impact of tooth brushing behavior on the incidences of future cardiovascular events in a general population including patients with cardiovascular disease. Methods: A total of the 692 participants (437 men and 255 women, mean age of 63 years) were enrolled in this study. The participants were divided into three groups according to the frequency and duration of tooth brushing: low frequency and short duration group (< twice/day and < 2 minutes/procedure), low frequency or short duration group (< twice/day or < 2 minutes/procedure), and non-low frequency and non-short duration group ( ≥ twice/day and ≥ 2 minutes/procedure). We assessed the associations of tooth brushing behavior with major adverse cardiovascular events (MACEs) including death from cardiovascular causes, acute myocardial infarction, hospitalization for heart failure, and stroke. Results: During a median follow-up period of 28.5 months (interquartile range, 15.4-35.1 months), 32 events occurred (10 deaths from cardiovascular causes, one acute myocardial infarction, 16 hospitalizations for heart failure, and eight strokes). Kaplan-Meier curves for MACEs among the groups were significantly different (P=0.001). After adjustment for cardiovascular risk factors, the combination of low frequency and short duration of tooth brushing was significantly associated with high incidences of MACEs compared with the incidences of MACEs for the combination of non-low frequency and non-short duration of tooth brushing (hazard ratio, 3.06; 95% confidence interval, 1.24-7.63; P=0.02). Conclusions: The combination of decreased frequency and duration of tooth brushing is associated with a higher risk of cardiovascular events.