HIROSHIMA, Japan — Brush your teeth and floss — for your heart’s sake! New research from Hiroshima University shows that a common gum infection called periodontitis may be linked to atrial fibrillation (AFib), or an irregular heartbeat.

It’s well-understood that periodontitis, more commonly referred to as gum disease, can lead to dental and mouth issues such as loss of teeth, bad breath, or bleeding. But it turns out that its effects could expand to the heart. The research team conducted their study with the goal of exploring this relationship on 76 patients with heart disease.

“Periodontitis is associated with a long-standing inflammation, and inflammation plays a key role in atrial fibrosis progression and atrial fibrillation pathogenesis,” says first author Shunsuke Miyauchi, assistant professor with the Hiroshima University’s Health Service Center, in a statement. Atrial fibrosis, which describes scarring of the heart, is a common feature of AFib.

“We hypothesized that periodontitis exacerbates atrial fibrosis. This histological study of left atrial appendages aimed to clarify the relationship between clinical periodontitis status and degree of atrial fibrosis,”Miyauchi adds.

Linking AFib and gum disease

For their work, the team removed the scarred parts of the heart and analyzed the tissue to understand the relationship between severity of gum disease and the scarring present. They found that if there was a correlation between them, discovering that the worse the gum infection, the worse the scarring. Their results suggest that the inflammation of gums may increase inflammation in the heart, ultimately leading to AFib.

“This study provides basic evidence that periodontitis can aggravate atrial fibrosis and can be a novel modifiable risk factor for atrial fibrillation,” said corresponding author Yukiko Nakano, professor of cardiovascular medicine in Hiroshima University’s Graduate School of Biomedical and Health Sciences.

Nakano says that as with almost any chronic condition, having a firm grip on maintaining a healthy weight, appropriate exercise frequency, and limited tobacco and alcohol use is important. However, she also adds that proper gum care may help improve cardiac care outcomes in people with AFib  She does still warn that this study only demonstrates a correlation, not a causation. Therefore, researchers have yet to produce clear evidence that can confidently say that one causes the other.

The team looks ahead to conducting clinical trials to further their reach, improving outcomes for patients everywhere.

“Further evidence is required for establishing that periodontitis contributes to the atrial fibrosis in a causal manner and that periodontal care can alter fibrosis,” Nakano says. “One of our goals is to confirm that periodontitis is a modifiable risk factor for atrial fibrillation and to promote dental specialists’ participation in comprehensive atrial fibrillation management. Periodontitis is an easy modifiable target with lower cost among known atrial fibrillation risk factors. Thus, the achievement of this study series may bring benefits for many people worldwide.”

The findings are published in the journal Clinical Electrophysiology.