title: Toothbrushing: A Link Between Noncommunicable and Communicable Diseases?
abstract: OBJECTIVE
  To assess the correlation between toothbrushing (TB) and the common biological (HDL) and quality-of-life-related risk factors for noncommunicable diseases (NCDs) and communicable diseases among patients with diabetes mellitus type 2 (DM2).
  
  
  METHODS
  The present study is part of a prospective intervention study among DM2 patients (n=200), randomly selected from the outpatient clinics, Istanbul, Turkey. The assessed variables were: TB, self-reported gingival bleeding (SRGB), HDL, BMI, body-fat proportion, modified quality of life scale (WHOQOL-BrefPhPs). Descriptive statistics, frequency distributions, Spearman rank correlation, the chi-square test and factor analysis were applied.
  
  
  RESULTS
  A minority of the patients brushed their teeth twice a day or more (27%) and reported no gingival bleeding (37%). Favourable HDL and high WHOQOL-BrefPhPs were 77% and 57%, respectively. A majority of patients had unhealthy BMI (83%) and body-fat proportions (63%). SRGB was negatively correlated with WHOQOL-BrefPhPs (rs=-0.24, p<0.05) and TB (rs=-0.25, p<0.01). The patients who reported less than daily TB were more likely to have unfavourable HDL and low WHOQOL-BrefPhPs (32% vs 54%) than those brushing their teeth daily (17% vs 35%, p<0.05). Principal component analysis revealed two clusters: 'healthy weight' (WHOQOL-BrefPhPs, TB, BMI) and 'oral health' (SRGB, HDL).
  
  
  CONCLUSIONS
  The present results demonstrate a correlation between TB and biological and quality-of-life-related risk markers of NCDs and communicable diseases. There seems to be a need to increase the awareness of the significance TB's potential intermediatory role between NCDs and communicable diseases.
authors.forename: Ayse Basak
authors.initials: AB
authors.lastname: Cinar
authors.forename: Inci
authors.initials: I
authors.lastname: Oktay
authors.forename: Lone
authors.initials: L
authors.lastname: Schou
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D050218:Body Fat Distribution; D015992:Body Mass Index; D001835:Body Weight; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood; D003141:Communicable Diseases; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000523:psychology; D005884:Gingival Hemorrhage / Q000150:complications / Q000523:psychology; D006442:Glycated Hemoglobin / Q000032:analysis; D015438:Health Behavior; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D009909:Oral Health; D025341:Principal Component Analysis; D011446:Prospective Studies; D011788:Quality of Life; D011897:Random Allocation; D014099:Toothbrushing / Q000706:statistics & numerical data*
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin