Until I was in my 20s, I mistakenly thought that teeth brushing (tooth brushing?) was all about the teeth – preventing their decay and making them look good. And since I’d already had a lot of cavities by that time anyway, the main reason to brush, to me, was to assure that those whites glistened when I smiled. It wasn’t until the day my regular dentist was out, and I saw his newly-minted associate fresh out of dental school, that I learned differently. Expecting a quick routine oral exam, imagine my surprise when he walked in holding a giant toothbrush the size of an axe, and a giant set of plastic teeth and proceeded to tell me how and why to brush.

At first, I was insulted. I know how to brush to my teeth, I thought. But as he continued talking, an entirely new concept about oral hygiene emerged for me. Yes, we may be brushing to prevent decay – although the foods one eats and other factors have as much to do with that; and yes, we may be keeping those pearly whites gleaming – but, as we now know, real stain removal from teeth requires a whitening method done over time. But, the main reason we should brush is to keep the gums clean, healthy, and free of infection. The gums?! Who had ever even considered taking care of the gums?

It turns out that oral hygiene and keeping the gums healthy is all about the normal bacteria that live in the mouth. Give those microbes food – they especially love sugar – and don’t brush or floss – and they will go to work wreaking havoc in the gums. They use the food, especially that remaining between the teeth, which allows them to multiply and burrow down into the gums, setting up housekeeping. And that’s how a gum or dental abscess starts. Continue to skip your oral hygiene for longer, and the plaque (that sticky, clear substance coating your gums and teeth) entraps the bacteria, holding them close to the gums and causing even more infection.

Nowadays we take for granted what that young dentist with the giant toothbrush was trying to tell me so many years ago. We know we should brush our teeth AND floss (or use the apparatus with a jet stream of water between the teeth, like a WaterPik) at least once daily, and if at all possible, twice daily and after eating. This is basic oral hygiene to keep us from getting gum or dental infections.

But what’s so bad about having a gum infection once in awhile, you may wonder? Especially since it can be easily treated with antibiotics? Besides the fact that using antibiotics too often can lead to antibiotic-resistant bacteria, it turns out that allowing inflammation and infection to fester in the mouth may lead to other more serious diseases. It has been thought for awhile now that inflammation in the mouth can lead to inflammation elsewhere in the body. Makes sense since the mouth is the gateway to much of the body. Prior research has actually shown an association between gum inflammation (periodontal disease) and cardiovascular (CV) disease.

Now comes a recent study in the British Medical Journal* that found that self-reported poor oral hygiene, defined as never or rare tooth brushing, is associated with a higher risk for CV events, such as a heart attack. In the 12,000 people (average age of 50) who were surveyed over 8 years, those who reported never, or rarely, brushing their teeth had a 70% higher risk for  CV events than did those who reported daily tooth brushing. Whether or not good oral hygiene actually prevents CV events is unknown at this time.

Though the fact that the participants in this study self-reported their habits, which could mean those that reported good oral hygiene may have been fudging, the association between gum inflammation and CV disease backs up prior research and bears further study. But remember that once upon a time many years ago, we only thought that smoking cigarettes might be bad for our health based on initial studies like these. And look how that has played out.

Bottom line: Good oral hygiene is a must, not only for your mouth alone, but potentially to keep your body healthy in general. Based on what we know thus far, it could be lifesaving. So, whenever you’re in a hurry and decide to skip your oral hygiene, think about a giant toothbrush and head back into the bathroom!

* de Oliveira C et al. Toothbrushing, inflammation, and risk of cardiovascular disease: Results from Scottish Health Survey. BMJ 2010 May 27; 340:c2451.