The effect of self-reported flossing behavior on cardiovascular disease events and mortality Findings from the 2009-2016 National Health and Nutrition Examination Surveys
BackgroundThere is increasing evidence suggesting that daily oral hygiene self-care measures may alleviate cardiovascular disease (CVD) risk. The authors aimed to determine the influence of self-reported dental flossing behavior on the prevalence of CVD events, CVD-linked mortality, and a CVD risk m...
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| مؤلفون آخرون: | , , , |
| التنسيق: | article |
| منشور في: |
2025
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| الموضوعات: | |
| الوصول للمادة أونلاين: | http://dx.doi.org/10.1016/j.adaj.2024.09.017 https://www.sciencedirect.com/science/article/pii/S0002817724005658 http://hdl.handle.net/10576/65935 |
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| _version_ | 1857415083688198144 |
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| author | Nebu, Philip |
| author2 | Tamimi, Faleh Al-Sheebani, Abdulla Almuzafar, Abdulrahman Shi, Zumin |
| author2_role | author author author author |
| author_facet | Nebu, Philip Tamimi, Faleh Al-Sheebani, Abdulla Almuzafar, Abdulrahman Shi, Zumin |
| author_role | author |
| dc.creator.none.fl_str_mv | Nebu, Philip Tamimi, Faleh Al-Sheebani, Abdulla Almuzafar, Abdulrahman Shi, Zumin |
| dc.date.none.fl_str_mv | 2025-07-02T05:26:04Z 2025-01-31 |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://dx.doi.org/10.1016/j.adaj.2024.09.017 Philip, N., Tamimi, F., Al-Sheebani, A., Almuzafar, A., & Shi, Z. (2025). The effect of self-reported flossing behavior on cardiovascular disease events and mortality: Findings from the 2009-2016 National Health and Nutrition Examination Surveys. The Journal of the American Dental Association, 156(1), 17-27. 00028177 https://www.sciencedirect.com/science/article/pii/S0002817724005658 http://hdl.handle.net/10576/65935 17-27 1 156 1943-4723 |
| dc.language.none.fl_str_mv | en |
| dc.publisher.none.fl_str_mv | Elsevier |
| dc.rights.none.fl_str_mv | http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Flossing cardiovascular disease periodontal disease oral hygiene mortality |
| dc.title.none.fl_str_mv | The effect of self-reported flossing behavior on cardiovascular disease events and mortality Findings from the 2009-2016 National Health and Nutrition Examination Surveys |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | BackgroundThere is increasing evidence suggesting that daily oral hygiene self-care measures may alleviate cardiovascular disease (CVD) risk. The authors aimed to determine the influence of self-reported dental flossing behavior on the prevalence of CVD events, CVD-linked mortality, and a CVD risk marker of inflammation (ie, C-reactive protein [CRP]). MethodsData from 18,801 adult participants of the 2009-2016 National Health and Nutrition Examination Surveys were analyzed with regard to flossing behavior, prevalence of CVD events, mortality cause data, and CRP levels. Information on mortality was obtained from the US mortality registry, updated to 2019. Participants who answered the flossing question were divided into 4 groups according to their frequency of flossing: not flossing (0 d/wk); occasional flossing (1-3 d/wk); frequent flossing (4-6 d/wk); and daily flossing (7 d/wk). Multiple logistic regression and Cox proportional hazard regression were used for analysis. ResultsDaily flossing was associated with lower prevalence of CVD events after adjusting for age, sex, sociodemographic factors, and lifestyle habits (model 2); the odds ratio was 0.71 (95% CI, 0.59 to 0.85) for CVD prevalence in the daily flossing group compared with the not flossing group. The odds ratio for CVD prevalence for each additional day of flossing was 0.95 (95% CI, 0.93 to 0.98; P for linear trend < .001) in model 2, and remained statistically significant after model 2 was further adjusted for metabolic syndrome. Daily flossing compared with not flossing was associated with lower risk of experiencing CVD mortality (hazard ratio, 0.64; 95% CI, 0.49 to 0.84) in model 2. The hazard ratio of CVD mortality for each additional day of flossing was 0.94 (95% CI, 0.90 to 0.98; P for linear trend = .002) in model 2. Participants in the not flossing group had significantly elevated CRP levels, even after multivariable adjustments. ConclusionsPoor flossing behavior is associated with higher prevalence of cardiovascular events, increased risk of experiencing CVD mortality, and elevated CRP levels. Practical ImplicationsImprovement in flossing behavior can have an additional benefit in the prevention of CVD events. Cardiologists need to advise patients to improve their personal oral hygiene practices, in addition to the standard diet and exercise advice. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | qu_0cbdf9ac7275f498ef2818cc31ff96d3 |
| identifier_str_mv | Philip, N., Tamimi, F., Al-Sheebani, A., Almuzafar, A., & Shi, Z. (2025). The effect of self-reported flossing behavior on cardiovascular disease events and mortality: Findings from the 2009-2016 National Health and Nutrition Examination Surveys. The Journal of the American Dental Association, 156(1), 17-27. 00028177 17-27 1 156 1943-4723 |
| language_invalid_str_mv | en |
| network_acronym_str | qu |
| network_name_str | Qatar University repository |
| oai_identifier_str | oai:qspace.qu.edu.qa:10576/65935 |
| publishDate | 2025 |
| publisher.none.fl_str_mv | Elsevier |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| spelling | The effect of self-reported flossing behavior on cardiovascular disease events and mortality Findings from the 2009-2016 National Health and Nutrition Examination SurveysNebu, PhilipTamimi, FalehAl-Sheebani, AbdullaAlmuzafar, AbdulrahmanShi, ZuminFlossingcardiovascular diseaseperiodontal diseaseoral hygienemortalityBackgroundThere is increasing evidence suggesting that daily oral hygiene self-care measures may alleviate cardiovascular disease (CVD) risk. The authors aimed to determine the influence of self-reported dental flossing behavior on the prevalence of CVD events, CVD-linked mortality, and a CVD risk marker of inflammation (ie, C-reactive protein [CRP]). MethodsData from 18,801 adult participants of the 2009-2016 National Health and Nutrition Examination Surveys were analyzed with regard to flossing behavior, prevalence of CVD events, mortality cause data, and CRP levels. Information on mortality was obtained from the US mortality registry, updated to 2019. Participants who answered the flossing question were divided into 4 groups according to their frequency of flossing: not flossing (0 d/wk); occasional flossing (1-3 d/wk); frequent flossing (4-6 d/wk); and daily flossing (7 d/wk). Multiple logistic regression and Cox proportional hazard regression were used for analysis. ResultsDaily flossing was associated with lower prevalence of CVD events after adjusting for age, sex, sociodemographic factors, and lifestyle habits (model 2); the odds ratio was 0.71 (95% CI, 0.59 to 0.85) for CVD prevalence in the daily flossing group compared with the not flossing group. The odds ratio for CVD prevalence for each additional day of flossing was 0.95 (95% CI, 0.93 to 0.98; P for linear trend < .001) in model 2, and remained statistically significant after model 2 was further adjusted for metabolic syndrome. Daily flossing compared with not flossing was associated with lower risk of experiencing CVD mortality (hazard ratio, 0.64; 95% CI, 0.49 to 0.84) in model 2. The hazard ratio of CVD mortality for each additional day of flossing was 0.94 (95% CI, 0.90 to 0.98; P for linear trend = .002) in model 2. Participants in the not flossing group had significantly elevated CRP levels, even after multivariable adjustments. ConclusionsPoor flossing behavior is associated with higher prevalence of cardiovascular events, increased risk of experiencing CVD mortality, and elevated CRP levels. Practical ImplicationsImprovement in flossing behavior can have an additional benefit in the prevention of CVD events. Cardiologists need to advise patients to improve their personal oral hygiene practices, in addition to the standard diet and exercise advice.Elsevier2025-07-02T05:26:04Z2025-01-31Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://dx.doi.org/10.1016/j.adaj.2024.09.017Philip, N., Tamimi, F., Al-Sheebani, A., Almuzafar, A., & Shi, Z. (2025). The effect of self-reported flossing behavior on cardiovascular disease events and mortality: Findings from the 2009-2016 National Health and Nutrition Examination Surveys. The Journal of the American Dental Association, 156(1), 17-27.00028177https://www.sciencedirect.com/science/article/pii/S0002817724005658http://hdl.handle.net/10576/6593517-2711561943-4723enhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:qspace.qu.edu.qa:10576/659352025-07-02T19:06:09Z |
| spellingShingle | The effect of self-reported flossing behavior on cardiovascular disease events and mortality Findings from the 2009-2016 National Health and Nutrition Examination Surveys Nebu, Philip Flossing cardiovascular disease periodontal disease oral hygiene mortality |
| status_str | publishedVersion |
| title | The effect of self-reported flossing behavior on cardiovascular disease events and mortality Findings from the 2009-2016 National Health and Nutrition Examination Surveys |
| title_full | The effect of self-reported flossing behavior on cardiovascular disease events and mortality Findings from the 2009-2016 National Health and Nutrition Examination Surveys |
| title_fullStr | The effect of self-reported flossing behavior on cardiovascular disease events and mortality Findings from the 2009-2016 National Health and Nutrition Examination Surveys |
| title_full_unstemmed | The effect of self-reported flossing behavior on cardiovascular disease events and mortality Findings from the 2009-2016 National Health and Nutrition Examination Surveys |
| title_short | The effect of self-reported flossing behavior on cardiovascular disease events and mortality Findings from the 2009-2016 National Health and Nutrition Examination Surveys |
| title_sort | The effect of self-reported flossing behavior on cardiovascular disease events and mortality Findings from the 2009-2016 National Health and Nutrition Examination Surveys |
| topic | Flossing cardiovascular disease periodontal disease oral hygiene mortality |
| url | http://dx.doi.org/10.1016/j.adaj.2024.09.017 https://www.sciencedirect.com/science/article/pii/S0002817724005658 http://hdl.handle.net/10576/65935 |