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Association between toothbrushing and risk factors for cardiovascular disease: a large-scale, cross-sectional
Masanari Kuwabara1, Yoko Motoki2, Kayoko Ichiura3
1Department of Cardiology, Toranomon Hospital, Tokyo, Japan Department of Cardiology, St Luke's International Hospital, Tokyo, Japan Department of Public Health, Jichi Medical University, Shimotsuke, Japan.
Insights
Brushing teeth less often is linked to higher rates of diabetes mellitus and dyslipidaemia. Regular toothbrushing may help prevent these systemic diseases.
Area of Science:
- Cardiovascular Disease Epidemiology
- Oral Health and Systemic Disease Linkages
- Preventive Medicine
Background:
- Cardiovascular disease risk factors include hypertension, diabetes mellitus, dyslipidaemia, hyperuricaemia, and chronic kidney disease.
- Toothbrushing frequency is a modifiable behavior with potential systemic health implications.
- Understanding the association between oral hygiene and systemic disease is crucial for public health.
Purpose of the Study:
- To investigate the relationship between toothbrushing frequency and the prevalence of key cardiovascular disease risk factors.
- To determine if toothbrushing habits are independently associated with hypertension, diabetes mellitus, dyslipidaemia, hyperuricaemia, and chronic kidney disease.
- To provide evidence supporting the role of oral hygiene in preventing systemic diseases.
Main Methods:
- A large-scale, cross-sectional study involving 85,866 participants.
- Participants were categorized by toothbrushing frequency: after every meal, at least once daily, or less than once daily.
- Binominal logistic regression analyses adjusted for age, gender, BMI, and lifestyle factors were used to calculate odds ratios.
Main Results:
- Lower toothbrushing frequency was significantly associated with higher prevalences of diabetes mellitus and dyslipidaemia.
- Specifically, brushing less than once a day increased the odds of diabetes mellitus (OR=2.03) and dyslipidaemia (OR=1.50) compared to brushing after every meal.
- No significant association was found between toothbrushing frequency and hypertension, hyperuricaemia, or chronic kidney disease.
Conclusions:
- Reduced toothbrushing frequency is linked to increased prevalence of diabetes mellitus and dyslipidaemia, even after controlling for lifestyle factors.
- These findings suggest that regular toothbrushing may contribute to the prevention of certain systemic diseases beyond oral health.
- Promoting consistent oral hygiene practices could be a valuable strategy in cardiovascular disease prevention efforts.
Objectives:
To clarify the association between toothbrushing and risk factors for cardiovascular disease--namely, hypertension (HT), diabetes mellitus (DM), dyslipidaemia (DL), hyperuricaemia (HUA) and chronic kidney disease (CKD).
Design:
A large-scale, single-centre, cross-sectional study.
Setting:
St Luke's International Hospital, Center for Preventive Medicine, Tokyo, Japan, between January 2004 and June 2010.
Participants:
This study examined the toothbrushing practices of 85,866 individuals according to the 3-category frequency criterion: 'after every meal', 'at least once a day' and 'less than once a day'. The ORs by frequency were calculated for the prevalences of HT, DM, DL, HUA and CKD according to binominal logistic regression analyses adjusted for age, gender, body mass index and lifestyle habits--smoking, drinking, walk time and sleep time.
Results:
The prevalences of the risk factors were as follows: HT ('after every meal': 13.3%, 'at least once a day': 17.9% and 'less than once a day': 31.0%), DM (3.1%, 5.3% and 17.4%, respectively), DL (29.0%, 42.1% and 60.3%, respectively), HUA (8.6%, 17.5% and 27.2%, respectively) and CKD (3.8%, 3.1% and 8.3%, respectively). The prevalences were significantly higher in the 'less than once a day' group than in the 'after every meal' group for DM (OR=2.03; 95% CI 1.29 to 3.21) and DL (OR=1.50; 95% CI 1.06 to 2.14), but not for HT, HUA and CKD.
Conclusions:
Even taking into account lifestyle habits, a lower frequency of toothbrushing was associated with high prevalences of DM and DL. Toothbrushing practices may be beneficial for oral health improvement and also for prevention of certain systemic diseases.
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