Physicians' Academy for Cardiovascular Education

Frequency and duration of tooth brushing is associated with endothelial function

Decreased frequency and duration of tooth brushing is a risk factor for endothelial dysfunction

Literature - Matsui S, Kajikawa M, Maruhashi T, et al. - Int J Cardiol 2017;241:30–34


Periodontal disease has been associated with an increased risk of CV and cerebrovascular diseases, since it promotes local and systemic inflammation and atherogenesis [1,2]. It has been shown that the decrease of tooth brushing frequency is independently associated with endothelial dysfunction [3], however, it is unclear whether the duration of tooth brushing on top of the frequency plays a role in this context.

In this study, the relationships of methods of tooth brushing with vascular function was evaluated, in 896 individuals, who were divided in 3 groups based on their tooth brushing behavior:

a) Low frequency and short duration: < twice/day and < 2 min/procedure

b) Low frequency or short duration: < twice/day or < 2 min/procedure

c) Non-low frequency and non-short duration: ≥ twice/day and ≥ 2 min /procedure

Oral health and tooth brushing behaviour were self-reported and captured on a questionnaire. Vascular function was measured by flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation in the brachial artery with high-resolution ultrasound [4,5].

Main results


Not only high frequency but also long duration of tooth brushing is associated with a better endothelial function. These results imply that adequate tooth brushing may be beneficial for the prevention of CV events, although further studies are needed to determine whether an increased frequency and duration of tooth brushing improves endothelial dysfunction.


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Find this article online at Int. J. Cardiol.