The Nighttime Habit That Is Quietly Raising Your Risk for Heart Disease

Skipping brushing before bed may raise inflammation and cardiovascular disease risk.

Reviewed by Dietitian Alyssa Pike, RDN

Key Points

• Skipping nighttime brushing is linked with cardiovascular disease risk.
• Gum inflammation may increase bacterial spread and inflammation.
• Bedtime brushing, drinking water and getting regular cleanings can support gum and heart health.

Skipping toothbrushing before bed may not seem like a big deal, but research suggests it could matter for more than just your teeth. Poor oral hygiene, especially when it leads to gingivitis (a form of gum disease marked by bleeding gums) or periodontitis (inflammation of the tissue around the teeth), has been linked with higher cardiovascular risk.

People who brush at night tend to have better cardiovascular outcomes than in those who do not, and more frequent toothbrushing and better dental hygiene is associated with lower cardiometabolic risk and mortality.

“It is a common and dangerous myth that oral health and overall health can be separated,” says dentist Fadi Swaida, D.D.S. “The mouth is part of the body, and with the chronic inflammation of gums, the issue does not stay localized.” How could something as simple as skipping nighttime brushing affect your heart? Read on to learn more.

Why Skipping Toothbrushing May Raise Your Heart Disease Risk

Skipping toothbrushing before bed matters because of what happens in your mouth while you sleep. Saliva production drops during sleep, giving plaque and bacteria more time to remain on teeth and gums. Over time, this may increase gum inflammation, which has been associated with vascular inflammation and heart disease risk.

Dentist Sandip Sachar, DDSsays, “There is indeed credible evidence linking poor oral hygiene with the increased risk of cardiovascular disease. Research suggests that skipping nighttime brushing is of particular importance.” Scientists believe this connection may be driven by inflammation and the spread of oral bacteria into the bloodstream, where it may cause inflammation in blood vessels and other parts of the body.

“[Nighttime brushing] is one of those things we should treat just like any other [cardiovascular] risk factor,” says cardiologist Wahaj Aman, MD “If you have high blood pressure, you’re at higher risk for heart disease. If you have diabetes, you’re at higher risk for heart disease. This is no different.”

Why Nighttime Toothbrushing Is So Important

Ashley Kitchens, M.P.H., RDN, LDNsays, “When you brush your teeth before bed, it removes plaque and bacteria buildup from the day, lowering your risk for both gum issues and heart impacts.” If plaque and food debris stay on your teeth and gums overnight, bacteria have more time to grow and irritate gum tissue.

Morning brushing still matters for oral health, but it may not fully make up for skipping the nighttime session. “Brushing in the morning is also important,” says Sachar. “It improves breath and removes overnight buildup, but does not protect the teeth and gums during the long hours of reduced saliva flow during sleep.”

Some research has found that frequent toothbrushing (defined as three or more times per day) is associated with lower risk of atrial fibrillation and heart failure over a median 10.5 years of follow-up. Regular professional dental cleaning was also associated with lower heart-failure risk.

So what can you do to protect your oral and heart health? Experts have a few tips for us.

Healthy Habits for Oral and Heart Health

These habits can help support both oral health and heart health.

• Brush and floss before bed, not just in the morning. “One of the strongest misconceptions that I see in my practice is that properly brushing in the morning alone is enough,” says Sachar.
• Stay on top of dental cleanings and gum symptoms. Professional cleanings every six to eight months can make a difference, too. “Getting your teeth professionally cleaned actually has an independent risk-lowering effect as well,” says Aman.
• Cut back on added sugars, especially late-night sweet drinks. Added sugars feed oral bacteria, and sugary beverages also work against heart health. “Choose water over sugary beverages when you can to help wash away bacteria,” says Kitchens.
• Build plates around fiber and vitamin C-rich produce, and limit salt, sugar and saturated fat. What you eat can impact both your gums and cardiovascular system. Sachar says, “I recommend a diet rich in fiber, vegetables, fruits and omega-3 fats that support a healthy inflammatory balance.”

Our Expert Take

While skipping toothbrushing at night does not directly cause heart disease, studies show a strong connection between poor oral hygiene, gum inflammation and worse cardiovascular health. To help reduce your risk of disease, brush and floss before bed, visit your dental hygienist often for cleanings, drink water instead of sugary late-night beverages, and eat a high-fiber, produce-rich diet that supports both gum and heart health.