Stroke
Dental flossing: A simple habit with potential stroke benefits
Clinical Takeaway: Ask patients about flossing habits and reinforce regular flossing as part of holistic cardiovascular and stroke prevention counseling.
Stroke remains a leading cause of death and disability, and a simple, low-cost habit was associated with about a 20% lower risk of ischemic stroke over nearly 24 years of follow-up.
In a prospective analysis from the ARIC (Atherosclerosis Risk in Communities) study, investigators followed 6,200 adults without prior stroke for a median of 23.7 years. About 65% reported regular dental flossing at baseline.
During follow-up, 434 ischemic strokes occurred. Nonflossers experienced higher rates of ischemic stroke (8.7% vs. 6.1%) and higher nonstroke mortality (40.8% vs. 34.5%). After multivariable adjustment, regular flossing was associated with a 23% lower risk of incident ischemic stroke (adjusted hazard ratio [aHR], 0.77; 95% confidence interval [CI], 0.64–0.96). The association was strongest for cardioembolic stroke, with a 40% lower risk among flossers (aHR 0.60; 95% CI, 0.38–0.94).
Flossing was also independently associated with a modest reduction in atrial fibrillation incidence (adjusted HR, 0.88; 95% CI, 0.77–0.99), with evidence of a dose-response relationship. Approximately 6.6% of the stroke risk reduction appeared to be mediated through lower afib risk.
“Dental flossing is a simple, affordable behavior that reduces oral infection and inflammation, which may have downstream benefits for atrial fibrillation and stroke,” said lead author Souvik Sen, MD, MPH.
The findings suggest that routine oral hygiene, beyond brushing alone, may play a small but meaningful role in long-term cerebrovascular risk reduction.
Source: Sen S, et al. (2026, April 8). Stroke. Dental Flossing May Lower the Risk for Incident Ischemic Stroke, Cardioembolic Stroke Subtype, and Atrial Fibrillation