Cardiovascular disease (CVD) is one of the major health issues of the day and the principal cause of death for communities throughout Europe[i]. According to NHS statistics[ii], chronic heart disease affects more than 2.6 million UK residents - approximately 0.6 million more men than women – and accounts for over 88,000 deaths annually, primarily from heart attacks.

CVD is a generic term encompassing a number of diseases of the circulatory system and the four main forms are coronary heart disease (CHD), stroke, peripheral arterial disease and aortic disease. Nearly half of CVD-related deaths in the European Union (EU) are due to CHD, followed closely behind by instances of stroke[iii].

Considering the widespread devastation it is causing, it is interesting to note that cardiovascular disease is largely influenced by lifestyle; with contributory factors ranging from an individual’s weight, diet and levels of physical activity to smoking habits and even stress. In effect, cardiovascular disease is - to a degree - avoidable. Further to this, research is increasingly coming to light demonstrating another link that brings control or even prevention of the disease back to the individual – oral hygiene.

A Scottish health survey[iv] has indicated an increased risk of heart disease for individuals who don’t undertake an adequate, regular oral hygiene routine. Of nearly 12,000 participants in the eight-year study, those with the poorest oral hygiene (who rarely or never brushed their teeth) were found to be up to 70% more likely to develop heart disease than others who brushed their teeth twice a day. They also had increased frequency of markers of low grade systemic inflammation. The results suggested that poor oral hygiene might increase the risk of developing CVD by means of periodontal infection.

Another study[v], a collaboration between the University of Bristol, Ireland’s Royal College of Surgeons and the State University of New York, has looked into the association between oral bacteria and heart disease. In particular, the researchers found the oral bacterium Streptococcus gordonii to be a plausible agent for CVD. Chronic oral disease, such as periodontitis, provides a pathway for the bacteria to access the bloodstream, where they can interact with platelets and induce aggregation. The study found that the S. gordonii could contribute towards unwanted blood clotting and the development of infective endocarditis.

Although heart disease remains the biggest killer in the UK, there is some good news on the horizon. The rate of deaths from coronary heart disease has been slowly but surely declining for the past three decades throughout much of Northern and Western Europe; and mortality rate following stroke is also decreasing[vi]. Heart attack related deaths in England have cut in half since 2002[vii] while public health targets, including reducing premature death from CVD by 40% by 2010, have been met[viii].

Interestingly, oral hygiene habits and oral health in the UK have likewise shown improvement in recent years; with the latest Adult Dental Health Survey establishing that 75% of adults brush their teeth at least twice daily[ix]. However, much fewer numbers use adjunctive interdental cleaning methods - just 22% floss, for example - and this could account in part for the high instances of plaque[x] which was found in two out of every three adults.

Clearly, tooth brushing along with fluoride toothpaste - although an excellent start - is not enough and it falls to the dental profession to help patients to maintain their own oral health with encouragement and advice. Patient education divides into three main aspects: which oral hygiene products are best for the individual patient to use, how to use them, and why it is so important to do so.

Most patients are aware of string floss for cleaning the interproximal spaces, but few are keen to use it and they frequently cite a lack of time or claim they forget to floss. In the majority of cases, patients struggle to use string floss properly and are more liable to give up quickly. In addition to this, research has thrown considerable doubt on the effectiveness of string flossing on reducing interproximal caries[xi] or inflammation.[xii] Perhaps it is time to give other interdental cleaning techniques a higher profile?

One method of quickly and efficiently cleaning between the teeth and below the gumline is the oral irrigator, also known as the Water Flosser. Easy to use and suitable for most patients, including those with braces or restorations, the leading Water Flosser can reduce gingivitis[xiii] and bleeding[xiv] and can help to minimise probing pocket depth[xv]. In particular, the Waterpik® Water Flosser is superior to dental floss at reducing gingival bleeding,[xvi] inflammation,[xvii] and plaque[xviii] with multiple patients including orthodontics, implants, and mild to moderate periodontitis. In fact, evidence shows that the Waterpik® Water Flosser removes up to 99.9% of plaque biofilm from any treated area of the tooth in just three seconds.[xix]

Through sound education on both the risks associated with poor oral health and the right tools for effective oral hygiene, we can help patients to prevent or control oral disease and help minimise the risk of developing or exacerbating chronic systemic disorders.

For more information on Waterpik® Water Flossers please speak to your wholesaler or visit www.waterpik.co.uk. Waterpik® products are widely available in Boots stores and selected Lloyds Pharmacies.