Impact of Oral Hygiene Practices in Reducing Cardiometabolic Risk, Incidence, and Mortality: A Systematic Review

Cardiometabolic diseases share many modifiable risk factors. However, periodontitis, a chronic inflammatory condition of the gums, is a risk factor that is rarely publicized. This systematic review aims to evaluate the impact of oral hygiene practices on the risk, incidence, and/or mortality rate of cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), and chronic kidney disease (CKD). Searches were conducted using MEDLINE, Embase, Scopus, and CINHAL. Randomized controlled trials (RCTs), quasi-RCTs, and observational studies were included. Eligible studies reported on associations of toothbrushing, interdental cleaning, mouthwash, or toothpaste use, either alone or in combination with CVD, CKD, and/or T2DM outcomes in adults ≥ 18 years. Fifty-five studies were included. Cochrane's risk of bias tool and the Newcastle-Ottawa Scale were used for quality assessment. Data synthesis is narratively presented. Toothbrushing and interdental cleaning were associated with lower risk of developing T2DM or hypertension HR 0.54 [p < 0.001] and a lower mortality risk in those with CVD HR = 0.25 [p = 0.03]. Mouthwash use reportedly increased the risk of developing hypertension and diabetes by 85% and 55%, respectively. This review highlights how simple oral hygiene practices can reduce cardiometabolic risk. Non-dental clinicians could integrate the findings into chronic disease health promotion.