title: Oral hygiene and cardiometabolic disease risk in the survey of the health of Wisconsin.
abstract: OBJECTIVE
  Poor oral health is an increasingly recognized risk factor for cardiovascular disease (CVD) and type 2 diabetes (T2D), but little is known about the association between toothbrushing or flossing and cardiometabolic disease risk. The purpose of this study was to examine the degree to which an oral hygiene index was associated with CVD and T2D risk scores among disease-free adults in the Survey of the Health of Wisconsin.
  
  
  METHODS
  All variables were measured in 2008-2010 in this cross-sectional design. Based on toothbrushing and flossing frequency, an oral hygiene index (poor, fair, good, excellent) was created as the primary predictor variable. The outcomes, CVD and T2D risk score, were based on previous estimates from large cohort studies. There were 712 and 296 individuals with complete data available for linear regression analyses in the CVD and T2D samples, respectively.
  
  
  RESULTS
  After covariate adjustment, the final model indicated that participants in the excellent (β ± SE = -0.019 ± 0.008, P = 0.020) oral hygiene category had a significantly lower CVD risk score as compared to participants in the poor oral hygiene category. Sensitivity analyses indicated that both toothbrushing and flossing were independently associated with CVD risk score, and various modifiable risk factors. Oral hygiene was not significantly associated with T2D risk score.
  
  
  CONCLUSIONS
  Regular toothbrushing and flossing are associated with a more favorable CVD risk profile, but more experimental research is needed in this area to precisely determine the effects of various oral self-care maintenance behaviors on the control of individual cardiometabolic risk factors. These findings may inform future joint medical-dental initiatives designed to close gaps in the primary prevention of oral and systemic diseases.
authors.affiliation: Epidemiology Research Center, Marshfield Clinic Research Foundation, Marshfield, WI 54449, USA. vanwormer.jeffrey@mcrf.mfldclin.edu
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: VanWormer
authors.forename: Amit
authors.initials: A
authors.lastname: Acharya
authors.forename: Robert T
authors.initials: RT
authors.lastname: Greenlee
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Nieto
mesh_terms: D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009910:Oral Hygiene / Q000706:statistics & numerical data*; D012306:Risk; D014922:Wisconsin
keywords: Cardiovascular Risk; oral hygiene; prevention