Interdental cleaning linked to lower blood glucose levels among people with type 2 diabetes
Good oral care habits such as interdental cleaning in people with type 2 diabetes are associated with better glycaemic control, new research shows.
Highlighting the importance of the connection between interdental cleaning and blood glucose levels, the results also indicate that prevention of tooth loss through good oral care habits and regular dental visits are important for people with type 2 diabetes from the perspective of better blood glycaemic control.
The joint study by the Clinic Masae Minami/Minami Diabetes Clinical Research Center and international oral healthcare company Sunstar investigated oral hygiene indicators and blood glycaemic control indicators, such as 24-hour continuous blood sugar fluctuations.
This study confirms the relationship between blood sugar fluctuations and the number of teeth in people with diabetes.
The results also make it clear that interdental cleaning habits and the number of teeth is related not only to measurements such as HbA1c and fasting blood sugar levels, but also to Time in Range, a figure that shows the amount of time an individual spends in the target blood glucose range between 70-180mg/dL during a 24-hour blood-sugar measurement.
That diabetes and periodontal disease are closely related was again demonstrated in a high-impact study a few years ago, showing that treating periodontal disease in people with type 2 diabetes improved glycaemic control.
Although there have been few reports on the relationship between oral hygiene habits and blood sugar control in people with diabetes, a previous study, which used the same study population as the present study, clarified the association between interdental cleaning habits, gender- and age-adjusted HbA1c, and fasting blood sugar levels.
The number of teeth is strongly related to interdental cleaning and dietary habits to maintain oral health.
Although the results of this study alone do not reveal a causal relationship, it is expected that incorporating regular dental visits and interdental cleaning into oral care will lead not only to the prevention of tooth loss but also to the maintenance and promotion of overall health.
The number of teeth was negatively correlated with age, the frequency of dental visits was positively correlated with age, and BMI, HbA1c, and fasting blood glucose level were negatively correlated.
Frequency of teeth brushing showed a negative correlation with male gender, BMI, urinary albumin/creatinine ratio, high-sensitivity CRP, and TNF-α. The frequency of interdental cleaning was positively correlated with time in range with male gender, BMI, high-sensitivity CRP, IL-6, and TNF-α.
Groups were divided according to whether or not they had interdental cleaning habits of at least three times per week, and large differences were seen when average glucose levels over 24 hours were plotted and compared.
Similar results were also obtained in comparison between the group with or without at least 20 teeth.
In comparison between groups for glycaemic indicators calculated from continuous glucose monitors CGM data, the group that had an interdental cleaning habit of at least three times per week had significantly lower total mean glucose levels than the group that did not, and Time in Range was higher.
Similarly, the group with at least 20 teeth had lower average glucose levels than the group that did not, and the Time in Range was higher.
When the Time-in-Range goal of 70 per cent was achieved/not achieved was used as the dependent variable and corrected for gender, age, and BMI, interdental cleaning habits (at least three times a week) became a significant independent variable.
Similar results were obtained in models in which inflammation-related indices were added as adjustment factors, suggesting that there is a mechanism mediated by factors other than inflammation.
The results of this study were presented at the 66th Annual Scientific Meeting of the Japan Diabetes Society in May 2023.
Photo by George Becker from Pexels