Oral hygiene's impact on cardiometabolic disease risk and mortality. A systematic review

Abstract

OBJECTIVES: The objective of this systematic review is to evaluate the impact of oral hygiene practices on the risk, incidence, and mortality associated with cardiometabolic diseases, specifically cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), and chronic kidney disease (CKD). METHODS: A comprehensive search was conducted across MEDLINE, Embase, Scopus, and CINHAL databases. Eligible studies included randomized controlled trials, quasi-randomized trials, and observational studies focusing on adults aged 18 years or older. The studies investigated associations between oral hygiene practices such as toothbrushing, interdental cleaning, and mouthwash use with the outcomes of CVD, T2DM, and CKD. Quality assessment was conducted using Cochrane's risk of bias tool and the Newcastle-Ottawa Scale. RESULTS: A total of 55 studies were included in the review. Toothbrushing and interdental cleaning were significantly associated with reduced risk of T2DM and hypertension, as well as lower mortality in individuals with CVD. Specifically, toothbrushing was correlated with a 46% reduction in the risk of T2DM and a 75% reduction in CVD-related mortality. However, the use of mouthwash was linked to increased risk of hypertension and diabetes by 85% and 55%, respectively. Toothpaste was not independently associated with disease outcomes. CONCLUSIONS: Oral hygiene practices, particularly regular toothbrushing and interdental cleaning, can significantly lower the risk of cardiometabolic diseases. Conversely, frequent mouthwash use may increase cardiometabolic risk. These findings suggest that non-dental healthcare providers should incorporate oral hygiene recommendations into chronic disease prevention and management strategies.