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Friday, June 4, 2010

Brush Those Teeth!

As I opine in this week's podcast, it seems curious to me that so many of our body parts are treated separately, as though feet, backs, and teeth were distinct entities. Indeed, I've often thought it would be great to simply drop my teeth off at the dentist and come back later to retrieve them but the fact is, they're attached to my jaw, and therefore to me and the rest of my body. Further evidence of their inextricable link emerges in a study in BMJ: Toothbrushing, inflammation, and risk of cardiovascular disease.

This study took a look at how often folks brushed their teeth (almost 12,000 of them! That's people, not teeth) and how that correlated with cardiovascular events, such as heart attacks or strokes, over an average follow up period of 8 years. Three levels of tooth hygiene were possible: less than once per day, once a day, or twice a day. Sure enough, there was a dose response. Those who brushed their teeth least were at the greatest risk of a cardiovascular event, with about a 70% greater chance of experiencing a heart attack or stroke compared with those who brushed twice a day. Seems compelling to Rick and me that twice a day interaction with a toothbrush is a good idea.

The study also measured blood levels of C-reactive protein, one marker of inflammation, and fibrinogen, a blood component related to clotting, in almost 5000 participants. Once again, higher levels of both of these blood markers were associated with less frequent tooth brushing.

Things not assessed in the study I would like to see would be flossing in addition to brushing, since presumably more of the bugs that reside in our mouths and may cause low grade inflammation are removed when we floss, and perhaps use of mouthwash and its potential impact. The inescapable conclusion, though, is that our oral health does impact general health. And as Rick points out, not only will our bodies be grateful for vigilant oral hygiene, so will those around us.

Other topics this week include treatment of one partner who is HIV positive and preventing infection in the other partner in the Lancet, timeliness of treatment for heart attack in JAMA, and group medical appointments in Annals of Internal Medicine. If you haven't looked at our YouTube we'd be so happy if you did! and until next week, y'all live well.

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