Toothbrushing, Blood Glucose and HbA1c: Findings from a Random Survey in Chinese Population.

Lingyu Su,Bingwu Xie,Lei Dou,Wenjuan Wan,Guangyue Li,Xiaoming Fu,Jiao Huang,Jun Sun,Ling Xu,Wenzhao Liu

doi:10.1038/srep28824

Abstract

Both diabetes and periodontal disease are prevalent in China. Poor oral hygiene practice is the major cause of periodontal disease. An association between oral hygiene practice and blood glucose level was reported in individuals with diabetes, but not in the general population. We examined the association in a population-based random survey recruiting 2,105 adults without previously diagnosed diabetes in Chongqing city, China. Plasma glucose and hemoglobin A1c (HbA1c) were measured, and a 2-hour oral glucose tolerance test was conducted for each respondent. Self-reported toothbrushing frequency was used as a proxy for oral hygiene practice. In a linear model controlling for potential confounders (demographic characteristics, socio-economic status, lifestyle risk factors, BMI, dental visit frequency, etc.), urban residents who barely brushed their teeth had an increase of 0.50 (95% CI: 0.10–0.90) mmol/L in fasting plasma glucose, and an increase of 0.26% (0.04–0.47%) in HbA1c, relative to those brushing ≥twice daily; for rural residents, the effects were 0.26 (0.05–0.48) mmol/L in fasting plasma glucose and 0.20% (0.09–0.31%) in HbA1c. Individuals with better oral practice tended to have lower level of blood glucose and HbA1c. Establishing good oral health behavioral habits may be conducive to diabetes prevention and control in the general population.

Highlights

Diabetes has become a major public health problem in China, increasing rapidly in last decades[1,2]
The highest level of fasting plasma glucose, 2-hour plasma glucose and hemoglobin A1c (HbA1c) were consistently found in respondents who barely or never brushed their teeth, whilst the lowest level of the three indictors were all found in those brushing teeth at least twice a day (Table 1)
2-hour plasma glucose, and HbA1c were higher in individuals who brushed their teeth less frequently

Summary

Introduction

Diabetes has become a major public health problem in China, increasing rapidly in last decades[1,2]. Self-reported measures of oral hygiene have been associated with periodontal disease[11]. A community based study analyzed data of routine health examination of 54,551 adults and reported that individuals who hardly brush teeth had higher odds of being diabetes (multivariate adjusted odds ratio: 1.61) than those who brush after each meal[12]. Several other studies revealed an association of toothbrushing behavior with HbA1c among diabetic patients[13,14]. The association between oral hygiene behavior with level of blood glucose and HbA1c has not been previously examined in the general population. We investigated whether and to what extent toothbrushing frequency is associated with the level of blood glucose and HbA1c in China

Methods

Results

Conclusion