So after a fun winter of use I finally decided to clean out my computer. HOLY DUSTBALLS BATMAN.
I ended up taking out and cleaning each of the 8 fans in my box and it took 2 compressed air canisters and a few static wipes to get everything clean. It is now finally nice and shiny.
I also ended up taking out 2 fans from my H100 push/pull config and now it is only push. It is almost silent now and still keeps my CPU idling at 40*C on the lowest setting for my fan.
At load, it is still dead quiet and never gets too high (40-55*C depending on the game or VM/dev configuration)
You don't need to do it every month, but a good cleaning every once in a while will help keep your system clean, healthy and may even improve performance. You may also find something broken or even gain new ideas for configuration.