What does brushing your teeth have to do with stroke? Doctor shares 5 daily habits that may raise risk apart from blood pressure and cholesterol

Stroke is often associated with familiar risk factors such as high blood pressure and cholesterol. But some everyday habits may also have a connection with stroke risk. Dr Priyam Bordoloi highlighted five such habits in a post on X, ranging from poor oral care and long working hours to smoking and ignoring signs of sleep apnea. He also discussed migraine aura and contraceptive pills, while stressing that some risks are difficult to change, but others can be controlled.

Brushing your teeth and stroke risk

Dr Priyam Bordoloi took to X to highlight what he described as five daily habits linked to stroke. He began with a surprisingly familiar routine: going to bed without brushing your teeth. According to the doctor, poor oral care can contribute to gum disease, while inflamed gums may allow bacteria to enter the bloodstream and contribute to inflammation. He noted that periodontal disease is strongly linked with stroke.

His advice was simple: brush twice a day, floss and do not ignore bleeding gums.

Working 55+ hours a week

Long working hours were another habit flagged by Dr Bordoloi. He pointed to a WHO analysis covering more than 839,000 people, which found that working 55 or more hours per week was associated with a 35% higher stroke risk compared with working 35 to 40 hours. The doctor noted that extended working hours can come at the expense of sleep, physical activity and recovery. While acknowledging that some people may not have complete control over their working schedules, he described chronic overwork as something that should not be treated as a badge of honour.

Ignoring loud snoring

Loud snoring can sometimes be dismissed as harmless, but Dr Bordoloi urged people to pay attention when it occurs alongside choking, gasping, breathing pauses or daytime sleepiness. These symptoms may point to sleep apnea. According to the doctor, repeated drops in oxygen levels and nighttime blood pressure surges can place stress on the arteries, while untreated sleep apnea is associated with increased stroke risk. Rather than simply relying on earplugs, he advised people experiencing these symptoms to get checked.

Smoking ‘just one’ cigarette

Dr Bordoloi also addressed the idea that smoking a single cigarette a day carries only a fraction of the risk of smoking a full pack. He cited a 141-study meta-analysis, which found that smoking one cigarette daily carried about 34% to 41% of the excess stroke risk seen with smoking 20 cigarettes a day. His point was that blood vessels do not offer a lower-risk category for people who consider themselves social smokers.

His recommendation was to aim for zero cigarettes rather than assuming that occasional smoking is harmless.

Starting the pill without mentioning migraine aura

The fifth habit concerned starting hormonal contraception without discussing migraine aura with a healthcare professional. Dr Bordoloi explained that migraine aura can involve symptoms such as flashing lights, zigzags, blind spots or tingling, and can increase the risk of ischemic stroke. If a contraceptive pill contains estrogen, he said, that risk may rise further.

He advised people not to stop medication on their own, but instead to discuss options such as progestin-only or nonhormonal contraception with their healthcare provider.

Dr Bordoloi acknowledges not every risk is easy to change

Dr Bordoloi also added an important caveat to his post, acknowledging that some stroke-related risks are harder to control than others. He noted that people whose jobs demand long hours may not always have a choice. Sharing his own experience, he said that during residency he worked around 100 hours a week for three years and could not follow the advice about limiting working hours himself.

However, he pointed out that there were still habits within his control, including brushing twice a day, avoiding smoking and acting on the risks he could change.