Stylized heart intertwined with a toothbrush, symbolizing the connection between oral hygiene and heart health.

The Gender Gap in Heart Health: Are Women Winning the Battle Against Endocarditis?

Rhea Morgan in Health & Wellness June 2025 • 4 min read.

"New research sheds light on why women with congenital heart disease may have a lower risk of infective endocarditis, highlighting the importance of oral hygiene and disease awareness."

Infective endocarditis (IE), an infection of the heart's inner lining or valves, poses a significant threat to individuals with congenital heart disease (CHD). While CHD increases the overall risk of IE, a curious disparity exists: women with CHD experience a 50% lower risk of IE compared to their male counterparts. This intriguing gender gap has prompted researchers to investigate potential explanations, with a spotlight on differences in oral hygiene practices.

Poor oral hygiene is a well-known risk factor for IE. The accumulation of plaque and calculus can lead to gingivitis and create opportunities for bacteria to enter the bloodstream during everyday activities like brushing. Current IE prevention guidelines emphasize the importance of maintaining optimal oral health, sometimes even more so than prophylactic antibiotics for dental procedures.

A recent study published in Open Heart sought to explore this gender-related difference by assessing self-reported dental hygiene habits and IE knowledge among adults with CHD. The findings offer valuable insights into the factors that may contribute to the lower IE incidence in women and underscore the significance of patient education and tailored preventative strategies.

Decoding the Disparity: Oral Hygiene Habits and IE Knowledge

Stylized heart intertwined with a toothbrush, symbolizing the connection between oral hygiene and heart health.

The study, conducted at the Center for Congenital Heart Disease of the University Hospital Inselspital in Bern, Switzerland, involved 187 adults with CHD at increased risk of IE. Participants completed a questionnaire assessing their knowledge of IE and their self-reported oral hygiene practices, including the frequency of tooth brushing and dental check-ups. Good oral hygiene was defined as brushing teeth twice daily and having a dental check-up at least once a year, aligning with American Dental Association recommendations.

Here's what the research revealed:

Knowledge is Key: Individuals with higher IE knowledge scores were more likely to report good oral hygiene practices.
Gender Matters: Women were significantly more likely than men to practice recommended dental care.
No Difference in Knowledge: Interestingly, there was no significant difference in IE knowledge scores between men and women.
Overall Good Hygiene: A substantial 67% of the participants reported maintaining good oral hygiene.

Multivariate analysis confirmed that female gender and a higher IE knowledge score were independent predictors of good oral hygiene practices. This suggests that women, regardless of their understanding of IE, are more inclined to follow recommended dental care routines. Furthermore, a better understanding of IE independently encourages individuals to adopt better oral hygiene habits.

Empowering Patients Through Education and Awareness

These findings reinforce the importance of patient education in preventing IE. By increasing awareness and understanding of the disease, healthcare professionals can empower individuals with CHD to take proactive steps in maintaining their oral health. While the study highlights a potential gender-related difference in oral hygiene practices, it emphasizes the need for tailored interventions that address the specific needs and behaviors of all patients at risk for IE. Further research is needed to explore the underlying reasons for these gender differences and to develop effective strategies for promoting optimal oral hygiene in both men and women with CHD.

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Everything You Need To Know

What is infective endocarditis, and why is it a concern for people with congenital heart disease?

Infective endocarditis (IE) is an infection that affects the inner lining of the heart or the heart valves. It's significant because individuals with congenital heart disease (CHD) are at a higher risk of developing IE. The infection occurs when bacteria enter the bloodstream and settle in the heart. Understanding IE is crucial for those with CHD to take preventive measures.

Why do women with congenital heart disease have a lower risk of infective endocarditis compared to men?

The study found that women with congenital heart disease (CHD) have a 50% lower risk of infective endocarditis (IE) compared to men with CHD. Researchers suggest that differences in oral hygiene practices may contribute to this gender disparity. While knowledge of IE is important, the study indicates women are more likely to practice good oral hygiene regardless of their IE knowledge.

Why is good oral hygiene important in preventing infective endocarditis, especially for those with congenital heart disease?

Good oral hygiene, defined as brushing teeth twice daily and having a dental check-up at least once a year, is important for preventing infective endocarditis (IE), especially for individuals with congenital heart disease (CHD). Poor oral hygiene can lead to the accumulation of plaque and gingivitis, creating opportunities for bacteria to enter the bloodstream and infect the heart. The American Dental Association provides guidelines on maintain oral health. Prevention guidelines emphasize maintaining optimal oral health.

What did the recent study reveal about the connection between knowledge of infective endocarditis and oral hygiene practices?

The study revealed that individuals with higher knowledge scores about infective endocarditis (IE) are more likely to practice good oral hygiene, and women are more likely than men to maintain recommended dental care routines. These findings emphasize the importance of patient education in promoting better oral hygiene habits. However, the study also points out that there was no significant difference in IE knowledge scores between men and women.

Why are patient education and awareness so important in preventing infective endocarditis, particularly for individuals with congenital heart disease?

Patient education and awareness are very important in preventing infective endocarditis (IE) in individuals with congenital heart disease (CHD). By increasing understanding of IE and its risk factors, healthcare professionals can empower patients to take proactive steps in maintaining their oral health. Tailored interventions are needed to address the specific needs and behaviors of all patients at risk for IE. The study underscores the importance of tailored preventive strategies and further research to develop effective strategies for promoting optimal oral hygiene in both men and women with CHD.