Oral health and longitudinal changes in fasting glucose levels: A nationwide cohort study

• Published in: PloS one 2021-06, Vol.16 (6), p.e0253769
• Main Authors: Song, Tae-Jin, Chang, Yoonkyung, Jeon, Jimin, Kim, Jinkwon
• Format: Article
• Language: English
• Subjects: Biology and Life Sciences; Blood Glucose - metabolism; Blood pressure; Body mass index; Brushing; Care and treatment; Codes; Cohort analysis; Dental caries; Dentists; Dextrose; Diabetes; Diabetes mellitus; Family income; Fasting; Fasting - blood; Female; Glucose; Gum disease; Health aspects; Hospitals; Humans; Hygiene; Hyperglycemia; Hypertension; Laboratory testing; Lifestyles; Longitudinal Studies; Male; Medical schools; Medical screening; Medicine; Medicine and Health Sciences; Middle Aged; Neurology; Oral Health; Oral hygiene; Periodontitis; Periodontitis - blood; Periodontitis - epidemiology; Physical Sciences; Questionnaires; Republic of Korea; Retrospective Studies; Standard error; Statistical analysis; Teeth; Tooth Loss - blood; Tooth Loss - epidemiology; Toothbrushing
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0253769

We investigated the association between oral hygiene indicators of periodontitis, tooth loss, and tooth brushing on the longitudinal fasting glucose level in non-diabetic subjects. Using a nationwide health screening database in Korea, we included non-diabetic individuals who received a health screening program with oral health check in 2009-2010. We constructed a linear mixed model for the longitudinal data of fasting glucose from the baseline to 2015. During the 4.84-year of median follow-up, 91,963 individuals (mean age 56.2 at baseline) underwent 392,780 health examinations with fasting glucose level (mmol/L). The presence of periodontitis was 39.3%. In the multivariate linear mixed analysis, periodontitis was related with increased fasting glucose levels (β = 0.0084, standard error = 0.0035, p = 0.018). Similarly, tooth loss was associated with increased level of fasting glucose (β = 0.0246, standard error = 0.0038, p < 0.001). Compared with tooth brushing ≤2 times/day, tooth brushing ≥3 times/day was associated with decreased fasting glucose levels (β = -0.0207, standard error = 0.0033, p < 0.001). Our data showed that periodontitis and tooth loss were associated with increased fasting glucose levels in non-diabetic individuals. The study findings imply that frequent tooth brushing may reduce fasting glucose levels. Further research is needed to determine the effect of periodontal intervention on glycemic control.