Floss to Prevent Stroke and Dementia: A Heartfelt Approach to Oral Hygiene

The Importance of Oral Hygiene

I loved sugar as a child. This was long before the days of fluoridated water, and as a result, I developed several cavities. My grandfather, Emmet, was a dentist. He repeatedly had to put fillings in my teeth, which was a lesson I learned the hard way.

During my time in medical school, I occasionally noticed redness and soreness in my gums. I instinctively knew this was a bad sign. Thus began my lifelong obsession with oral hygiene.

My family often teases me about my dental regimen. It includes flossing, using my Waterpik, and brushing with a Sonicare toothbrush at least twice a day. I also get dental cleanings every six months, avoid all added sugar products, and follow a Pesco-Mediterranean diet.

The Link Between Oral Health and Brain Health

Poor oral hygiene can lead to long-term systemic inflammation, a known risk factor for cognitive decline and neurodegeneration. Inflammation from gum disease may act as a chronic stressor on the brain, increasing the risk of Alzheimer’s disease and other forms of dementia.

A study reported earlier this year, based on the Atherosclerosis Risk in Communities (ARIC), assessed the oral hygiene habits of over 6,000 participants over a 25-year period.

Participants who flossed regularly had a 22% lower risk of ischemic stroke, a 44% lower risk of stroke caused by a blood clot traveling from the heart to the brain, and a 12% lower risk of atrial fibrillation (AFIB) compared to those who didn’t floss.

For long-term brain health, it’s essential to get into the habit of flossing daily along with brushing your teeth at least twice a day for two minutes, ideally with an electric toothbrush.

Make sure to get twice-yearly dental cleanings and checkups.

Integrating these dental hygiene practices into your routine is a key component of a long-term brain protection and stroke prevention strategy. This strategy also includes:

• Keeping blood pressure in the normal range

• Getting daily exercise

• Treating high LDL (and Apo B) cholesterol levels

• Avoiding excess alcohol consumption

Get Vaccines to Reduce Risk of Alzheimer’s

Accumulating scientific evidence strongly suggests that the shingles vaccine lowers the risk of Alzheimer’s disease.

Multiple large-scale cohort studies and natural experiments have consistently demonstrated that the herpes zoster (shingles) vaccination is associated with a significantly reduced risk of developing dementia, including Alzheimer’s disease.

These studies reported 15–35% lower risks for developing Alzheimer’s disease with both the Zostavax and Shingrix zoster vaccines.

These vaccine-related brain protective benefits persisted even after adjusting for confounding factors and across different demographic subgroups.

The Benefits of Vaccination

Be aware that the shingles vaccine can make you feel like you have the flu for about 24 hours afterward. Symptoms may include fatigue, muscle aches, headache, and a sore arm at the injection site.

This reaction is actually a good thing. It means your immune system was activated and mounted a defense against the viral proteins. This not only protects you from getting shingles in the future but might also protect your brain from dementia as a bonus.

Serious adverse effects from the shingles vaccine are very rare—about three cases per million doses.

The mechanism for brain protection from the shingles vaccine is not fully established, but hypotheses include:

• Nonspecific immune-related neuroprotection

• Reduction of neuroinflammation

• Prevention of viral reactivation in the brain

  
  

Interestingly, the protective effect is not unique to shingles vaccination. Other adult vaccines, like the flu vaccine (influenza), pneumococcal vaccine (pneumonia), and TDaP vaccine (tetanus, diphtheria, and pertussis), are similarly associated with reduced dementia risk.

Dementia Risk Reduction Associated with Adult Vaccines

Vaccine	Dementia Risk Reduction	Strength of Evidence
Shingles (Shingrix)	20–30%	Moderate to strong
Influenza	30–40%	Strong (multiple studies)
Tdap (Tetanus booster)	30–50%	Moderate
Pneumococcal	20–30%	Moderate

While causation isn’t yet proven, the correlation is strong and consistent. Staying up to date on routine adult vaccinations—particularly against flu, pneumococcal, and tetanus—may contribute to a reduced risk of Alzheimer’s.

This adds to their already substantial benefits in preventing infectious diseases.

Build Strong Muscles to Protect Against Alzheimer’s

Large-scale studies have shown that diminished muscular strength (particularly grip strength) is associated with a higher risk of cognitive decline and Alzheimer’s disease.

A 2022 study published in JAMA Network Open found that individuals with higher levels of muscle strength had a significantly lower risk of developing dementia, independent of other factors like age or lifestyle.

The Role of Muscle Strength

Muscle strength may be a more reliable predictor than muscle mass itself—meaning function matters more than size.

Strong muscles improve blood flow, insulin sensitivity, and glucose metabolism, all of which are critical for brain function. Active and strong muscles produce myokines, signaling proteins with anti-inflammatory and neuroprotective effects.

Exercise, including resistance training, increases Brain-Derived Neurotrophic Factor (BDNF), which promotes the survival and growth of neurons and improves memory and learning.

Muscle strength is linked to a lower risk of diabetes, cardiovascular disease, and obesity, all of which are major risk factors for Alzheimer’s. Strength training supports overall physical activity levels, contributing to cognitive reserve—the brain’s ability to resist damage.

The Benefits of an Active Lifestyle

Active individuals tend to have better sleep, mood, and social engagement, all of which lower dementia risk.

Maintaining muscle strength through resistance training or weightlifting and aerobic exercise is one of the most accessible, evidence-backed ways to reduce Alzheimer’s risk.

It’s not a silver bullet, but it’s a powerful part of a prevention strategy. This strategy is especially effective when combined with the steps mentioned above and these habits:

• A healthy diet (like the Mediterranean or MIND diet)

• Good sleep

• Engaging in challenging tasks like real-world problem-solving or learning a new language, musical instrument, or computer program

• Social interaction and emotional support

  
  

Conclusion

In conclusion, taking care of your oral hygiene, staying up-to-date with vaccinations, and building muscle strength are all vital steps in protecting your brain health.

By incorporating these practices into your daily life, you can significantly reduce your risk of cognitive decline and live a longer, healthier, and more joyful life. Remember, every small step counts toward a brighter future for your brain and heart health.