Goed tanden poetsen tegen hartproblemen*
Uit een Schotse studie onder bijna 12.000 Schotten, mannen en vrouwen in de leeftijd van 50 jaar, blijkt dat slecht en maar een keer of minder per dag
tanden poetsen de kans op hart- en vaatziekten aanzienlijk doet toenemen. In de praktijk zijn slechte poetsers vooral laagopgeleide, oudere mannen, die ook vaak roken. Zij die een keer per dag hun tanden poetsen hebben 30-40% meer kans op hartproblemen, zij die maar af en toe hun tanden poetsen hebben wel 70% meer kans en dat in vergelijking met zij die 2 keer per dag hun tanden poetsen.
Wie niet poetst heeft veel tandplaque en daarin groeien bacteriën. Via ontstoken tandvlees kunnen die in de bloedbaan terechtkomen. Ze kunnen blijven hangen in het hart en hartklepontstekingen of bloedstolsels veroorzaken. In het bloed van de slechte poetsers waren, meer dan bij goede poetsers moleculen te vinden die vrijkomen bij chronische ontstekingen, zoals C reactive protein (CRP) en fibrinogeen. Dat ondersteunt de theorie dat een forse populatie mondbacteriën een chronische ontsteking veroorzaakt. Het was al bekend dat mensen met
tandvleesontstekingen (parodontitis) meer moeten vrezen voor een hartziekte.
Research
Toothbrushing, inflammation, and risk of cardiovascular disease: results from Scottish Health Survey
Cesar de Oliveira, research fellow in epidemiology and public health, Richard Watt, professor and honorary consultant in dental public health, Mark Hamer, senior research fellow in epidemiology and public health
1 Department of Epidemiology and Public Health, University College London, London WC1E 6BT
Correspondence to: R Watt r.watt@ucl.ac.uk
Objective To examine if self reported toothbrushing behaviour is associated with cardiovascular disease and markers of inflammation (C reactive protein) and coagulation (fibrinogen).
Design National population based survey.
Setting Scottish Health Survey, which draws a nationally representative sample of the general population living in households in Scotland.
Participants 11 869 men and women, mean age 50 (SD 11).
Main outcome measures Oral hygiene assessed from self reported frequency of toothbrushing. Surveys were linked prospectively to clinical hospital records, and Cox proportional hazards models were used to estimate the risk of cardiovascular disease events or death according to oral hygiene. The association between oral hygiene and inflammatory markers and coagulation was examined in a subsample of participants (n=4830) by using general linear models with adjustments.
Results There were a total of 555 cardiovascular disease events over an average of 8.1 (SD 3.4) years of follow-up, of which 170 were fatal. In about 74% (411) of cardiovascular disease events the principal diagnosis was coronary heart disease. Participants who reported poor oral hygiene (never/rarely brushed their teeth) had an increased risk of a cardiovascular disease event (hazard ratio 1.7, 95% confidence interval 1.3 to 2.3; P<0.001) in a fully adjusted model. They also had increased concentrations of both C reactive protein (β 0.04, 0.01 to 0.08) and fibrinogen (0.08, –0.01 to 0.18).
Conclusions Poor oral hygiene is associated with higher levels of risk of cardiovascular disease and low grade inflammation, though the causal nature of the association is yet to be determined.
© de Oliveira et al 2010
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license
Cite this as: BMJ 2010;340:c2451 (Juni 2010)
