title: Tooth brushing and cardiometabolic risk factors in adolescents: Is there an association? The CASPIAN-III study.
abstract: BACKGROUND
  A growing body of evidence supports an association between oral health and cardiovascular diseases and diabetes in adults. This study aimed to investigate the relationship between tooth brushing frequency and cardiometabolic risk factors in adolescents.
  
  
  METHODS
  This nationwide population-based study was conducted among 5258 Iranian students, aged 10-18 years, living in urban and rural areas of 27 provinces in Iran. The association of tooth brushing frequency was assessed with anthropometric indexes and cardiometabolic risk factors after adjustment for potential confounders.
  
  
  RESULTS
  Higher frequency of tooth brushing was associated with lower mean levels of low-density lipoprotein cholesterol (LDL-C) in both genders (P < 0.0001) and lower frequency of elevated LDL-C in girls (P = 0.03). The frequency of elevated blood pressure decreased with higher tooth brushing frequency in boys (P = 0.03). After adjustment for many potential cofounders such as age, gender, anthropometric indexes, screen time, socioeconomic status, and family history of non-communicable diseases, participants who washed their teeth at least once a day had lower risk of high LDL-C and low high-density lipoprotein cholesterol (HDL-C) levels in comparison to those who reported lower frequency of tooth brushing; some different associations were observed among girls and boys.
  
  
  CONCLUSIONS
  Our findings suggest an independent and protective role of teeth brushing frequency for some cardiometabolic risk factors in adolescents. Increasing both the general health awareness and improving oral health should be considered in primordial and primary prevention of non-communicable diseases.
authors.affiliation: Department of Pediatrics, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
authors.forename: Parisa
authors.initials: P
authors.lastname: Mirmoghtadaee
authors.forename: Mostafa
authors.initials: M
authors.lastname: Qorbani
authors.forename: Mohammad Esmaeil
authors.initials: ME
authors.lastname: Motlagh
authors.forename: Ramin
authors.initials: R
authors.lastname: Heshmat
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Taslimi
authors.forename: Minoosadat
authors.initials: M
authors.lastname: Mahmoudarabi
authors.forename: Gelayol
authors.initials: G
authors.lastname: Ardalan
authors.forename: Bagher
authors.initials: B
authors.lastname: Larijani
keywords: Blood pressure; cardiometabolic risk factors; lipid profile; obesity; prevention; tooth brushing