Oral Health, Diabetes, and Inflammation: Effects of Oral Hygiene Behaviour

Luo, Huabin; Wu, Bei; Kamer, Angela R.; Adhikari, Samrachana; Sloan, Frank A.; Plassman, Brenda L.; Tan, Chenxin; Qi, Xiang; Schwartz, Mark D.

doi:10.1016/j.identj.2021.10.001

Cited by 19 publications

(17 citation statements)

References 29 publications

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“…Our intervention is based on evidence showing that inadequate oral hygiene practices are a major contributing factor for poor oral health. [17][18][19] Our previous study found that only 36% of individuals with cognitive impairment brushed their teeth two times a day, as compared with 72% of those with normal cognition and frequency of toothbrushing was associated with better oral health outcomes than among people with cognitive impairment, 8 a finding consistent with well-established evidence that regular and proper toothbrushing helps prevent plaque build-up. [17][18][19] Plaque control can lessen or prevent severe oral health conditions such as dental caries and periodontal disease.…”

Section: Open Accesssupporting

confidence: 62%

“…[17][18][19] Our previous study found that only 36% of individuals with cognitive impairment brushed their teeth two times a day, as compared with 72% of those with normal cognition and frequency of toothbrushing was associated with better oral health outcomes than among people with cognitive impairment, 8 a finding consistent with well-established evidence that regular and proper toothbrushing helps prevent plaque build-up. [17][18][19] Plaque control can lessen or prevent severe oral health conditions such as dental caries and periodontal disease. We propose that an intervention to improve the quality and frequency of toothbrushing for community-dwelling individuals with mild dementia would have similar positive results.…”

Section: Open Accesssupporting

confidence: 62%

“…Thus, our intervention aims to improve oral health and reduce risk of oral health problems among people with mild dementia living in the community. Our intervention is based on evidence showing that inadequate oral hygiene practices are a major contributing factor for poor oral health 17–19. Our previous study found that only 36% of individuals with cognitive impairment brushed their teeth two times a day, as compared with 72% of those with normal cognition and frequency of toothbrushing was associated with better oral health outcomes than among people with cognitive impairment,8 a finding consistent with well-established evidence that regular and proper toothbrushing helps prevent plaque build-up 17–19.…”

Section: Introductionmentioning

confidence: 52%

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Study protocol for a randomised controlled trial of a care partner assisted intervention to improve oral health of individuals with mild dementia

Plassman²,

Poole³

et al. 2022

BMJ Open

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IntroductionIndividuals with mild dementia are at high risk of poor oral health outcomes. To address this issue, we describe an intervention to teach care partners skills to guide individuals with mild dementia in proper oral hygiene techniques and provide reminders to practice oral hygiene care. By providing support to perform these tasks successfully, we aim to delay oral health decline among this vulnerable population.Methods and analysisThis multisite study is a three-arm randomised controlled trial. The primary objective is to evaluate the efficacy of an intervention to improve oral hygiene outcomes by promoting positive oral hygiene behaviours and skills among individuals with mild dementia. Care partners’ behaviour factors, such as oral care self-efficacy and implementation of the care plan, serve as mediators of the intervention. Participant–care partner dyads will be randomly assigned to either Treatment Group 1, Treatment Group 2 or the Control Group. All groups will receive an educational booklet. Treatment Group 1 and Treatment Group 2 will receive a smart electronic toothbrush. Treatment Group 2 (the intervention group) will also receive an oral hygiene care skill assessment, personalised oral hygiene instruction and treatment plan; and care partners will receive in-home and telephone coaching on behaviour change. Oral health outcomes will be compared across the three groups. The duration of the active intervention is 3 months, with an additional 3-month maintenance phase. Data collection will involve three home visits: baseline, 3 months and 6 months. The study enrollment started in November 2021, and the data collection will end in Spring 2024.Ethics and disseminationThe study has been approved by the Institutional Review Board of the NYU Grossman School of Medicine and Duke University, and is registered at Clinicaltrials.gov. A Data Safety Monitoring Board has been constituted. The study findings will be disseminated via peer-reviewed publications, conference presentations and social media.Trial registration numberNCT04390750.

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Section: Open Accesssupporting

confidence: 62%

Section: Open Accesssupporting

confidence: 62%

Section: Introductionmentioning

confidence: 52%

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Study protocol for a randomised controlled trial of a care partner assisted intervention to improve oral health of individuals with mild dementia

Plassman²,

Poole³

et al. 2022

BMJ Open

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“…Due to our cross-sectional design and the lack of biomarker measures in NHANES 2011-2014, we were not able to evaluate whether the relationship between ossing and glycemic control potentially is related to a reduction of systemic in ammatory burden. A recent pathway analysis using NHANES 2009-2010 data provided limited evidence to support this hypothesis (21). Luo and colleagues reported ossing mitigates the effect of poor oral health on systemic in ammation as measured by Creactive protein (21).…”

Section: Discussionmentioning

confidence: 99%

“…A recent pathway analysis using NHANES 2009-2010 data provided limited evidence to support this hypothesis (21). Luo and colleagues reported ossing mitigates the effect of poor oral health on systemic in ammation as measured by Creactive protein (21). As others have observed, even very minor changes in HbA1c can have a major impact on clinical outcomes in diabetes (12).…”

Section: Discussionmentioning

confidence: 99%

Association Between Preventive Dental Visits and Flossing with Periodontitis and Diabetes Control – National Health and Nutrition Examination Survey, 2011-2014

Zhang

Leveille

Camhi

et al. 2023

Preprint

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Background Diabetes and periodontitis are two intertwined chronic diseases linked by the inflammatory mechanism. Experimental studies indicate that treating periodontitis may benefit glycemic control among people with diabetes. It is not clear whether good oral self-care behaviors such as flossing may reduce risk for periodontitis and improve glycemic control among diabetes populations. The purpose of this study was to examine the associations between flossing and preventive dental care with periodontitis and glycemic control among US dentate adults with diabetes. Methods We analyzed data from the National Health and Nutrition Examination Survey 2011–2014 for 892 participants aged 30 years and older with diabetes who completed the periodontal examination and lab test for hemoglobin A1c (HbA1c). Sampling weights were applied. Multivariable logistic regression and multivariable linear modeling were performed to examine the effects of flossing and preventive dental services on periodontal health and HbA1c levels, respectively, controlling for sociodemographic characteristics, body mass index(BMI), smoking, and other risk factors. Results Among U.S. dentate adults with diabetes, 52.1% of flossers and 72.1% of non-flossers had periodontitis (p < 0.001). Flossers were 39% less likely to have periodontitis (Adj. OR 0.61, 95% CI 0.43–0.88) compared to non-flossers. Flossers had an average HbA1c reading 0.30% (95% CI 0.02% − 0.58%) lower than non-flossers, adjusted for covariates (p = 0.037). Conclusion Flossing was associated with better periodontal health and glycemic control among US dentate adults with diabetes. Although longitudinal and experimental studies are needed, the findings support that emphasis on oral self-care may be particularly beneficial for adults with diabetes.

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Periodontal treatment associated with decreased diabetes mellitus–related treatment costs

Thakkar‐Samtani¹,

Heaton²,

Kelly³

et al. 2023

The Journal of the American Dental Association

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Oral Health, Diabetes, and Inflammation: Effects of Oral Hygiene Behaviour

Cited by 19 publications

References 29 publications

Study protocol for a randomised controlled trial of a care partner assisted intervention to improve oral health of individuals with mild dementia

Study protocol for a randomised controlled trial of a care partner assisted intervention to improve oral health of individuals with mild dementia

Association Between Preventive Dental Visits and Flossing with Periodontitis and Diabetes Control – National Health and Nutrition Examination Survey, 2011-2014

Periodontal treatment associated with decreased diabetes mellitus–related treatment costs

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