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Association between toothbrushing and risk factors for cardiovascular disease: a large-scale, cross-sectional Japanese study
  1. Masanari Kuwabara1,2,3,
  2. Yoko Motoki4,
  3. Kayoko Ichiura5,
  4. Mizue Fujii6,
  5. Chisato Inomata7,
  6. Hiroki Sato8,
  7. Taichiro Morisawa9,
  8. Yoshinori Morita10,
  9. Kazumichi Kuwabara11,
  10. Yosikazu Nakamura3
  1. 1Department of Cardiology, Toranomon Hospital, Tokyo, Japan
  2. 2Department of Cardiology, St Luke's International Hospital, Tokyo, Japan
  3. 3Department of Public Health, Jichi Medical University, Shimotsuke, Japan
  4. 4Department of Obstetrics, Gynecology and Molecular Reproductive Science, Yokohama City University Graduate School of Medicine, Yokohama, Japan
  5. 5Department of Clinical Nursing, Shiga University of Medical Science, Otsu, Japan
  6. 6School of Nursing, Sapporo City University, Sapporo, Japan
  7. 7Graduate School of Dentistry, Osaka University, Osaka, Japan
  8. 8Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
  9. 9Department of Internal Medicine and Cardiology, Tama-Nagayama Hospital, Nippon Medical School, Tokyo, Japan
  10. 10Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan
  11. 11Asa-Gion Dental Clinic, Hiroshima, Japan
  1. Correspondence to Dr Masanari Kuwabara; kuwamasa728{at}


Objectives To clarify the association between toothbrushing and risk factors for cardiovascular disease—namely, hypertension (HT), diabetes mellitus (DM), dyslipidaemia (DL), hyperuricaemia (HUA) and chronic kidney disease (CKD).

Design A large-scale, single-centre, cross-sectional study.

Setting St Luke's International Hospital, Center for Preventive Medicine, Tokyo, Japan, between January 2004 and June 2010.

Participants This study examined the toothbrushing practices of 85 866 individuals according to the 3-category frequency criterion: ‘after every meal’, ‘at least once a day’ and ‘less than once a day’. The ORs by frequency were calculated for the prevalences of HT, DM, DL, HUA and CKD according to binominal logistic regression analyses adjusted for age, gender, body mass index and lifestyle habits—smoking, drinking, walk time and sleep time.

Results The prevalences of the risk factors were as follows: HT (‘after every meal’: 13.3%, ‘at least once a day’: 17.9% and ‘less than once a day’: 31.0%), DM (3.1%, 5.3% and 17.4%, respectively), DL (29.0%, 42.1% and 60.3%, respectively), HUA (8.6%, 17.5% and 27.2%, respectively) and CKD (3.8%, 3.1% and 8.3%, respectively). The prevalences were significantly higher in the ‘less than once a day’ group than in the ‘after every meal’ group for DM (OR=2.03; 95% CI 1.29 to 3.21) and DL (OR=1.50; 95% CI 1.06 to 2.14), but not for HT, HUA and CKD.

Conclusions Even taking into account lifestyle habits, a lower frequency of toothbrushing was associated with high prevalences of DM and DL. Toothbrushing practices may be beneficial for oral health improvement and also for prevention of certain systemic diseases.

  • Toothbrushing
  • Diabetes mellitus
  • Dyslipidemia

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