Dental Flossing May Lower the Risk for Incident Ischemic Stroke, Cardioembolic Stroke Subtype, and Atrial Fibrillation

BACKGROUND: Prior studies have demonstrated an association between oral infection and both incident stroke and atrial fibrillation (AF), a major cause of cardioembolic stroke. However, the impact of preventive oral behaviors such as dental flossing on incident stroke and AF remains unclear. We evaluated the relationship between flossing, incident stroke subtypes, and AF from the ARIC study (Atherosclerosis Risk in Communities). METHODS: We conducted a prospective cohort study using data from the ARIC study. Flossing was assessed via a structured questionnaire at visit 4 (1996-1998). Participants were censored at the first stroke, death, or loss-to-follow-up through December 31, 2021. Incident ischemic stroke and subtypes were evaluated using Cox proportional hazards models, adjusting for cardiovascular risk factors, education, regular brushing, dental care utilization, periodontal disease, and dental caries. RESULTS: value of 1.87. CONCLUSIONS: Regular flossing was associated with a lower risk of ischemic stroke, primarily driven by reductions in cardioembolic stroke and AF, independent of other oral health behaviors. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT00005131.