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Meta‐analysis on the association between the frequency of tooth brushing and diabetes mellitus risk
Author(s) -
Fu Wenning,
Lv Chuanzhu,
Zou Li,
Song Fujian,
Zeng Xiantao,
Wang Chao,
Yan Shijiao,
Gan Yong,
Chen Fan,
Lu Zuxun,
Cao Shiyi
Publication year - 2019
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.3141
Subject(s) - tooth brushing , medicine , observational study , epidemiology , diabetes mellitus , odds ratio , meta analysis , cohort study , dentistry , endocrinology , brush , toothbrush , electrical engineering , engineering
Background and Objective Epidemiological studies suggested that the frequency of tooth brushing might be associated with the risk of diabetes mellitus (DM), but the results were inconsistent, and no systematic review was conducted to focus on this topic. In this meta‐analysis, we synthesized available observational epidemiological evidences to identify the association between tooth brushing and DM risk and investigate the potential dose‐response relationship of them. Methods We searched PubMed and Embase from their inception through December 2017 to identify observational studies examining the association between tooth brushing and the risk of DM. Reference lists from retrieved articles were also reviewed. We quantitatively combined results of the included studies using a random‐effects model. Dose‐response meta‐analysis was conducted to further examine the effect of tooth brushing frequency on DM risk. Results We identified 20 relevant studies (one cohort study, 14 case‐control studies, and 5 cross‐sectional studies) involving 161 189 participants and 10 884 patients with DM. Compared with the highest tooth brushing frequency, the lowest level was significantly associated with an increased risk of DM (OR 1.32; 95% CI, 1.19‐1.47), and there was no significant heterogeneity across the included studies ( p = 0.119, I 2 = 28.1%). Exclusion of any single study did not materially alter the combined risk estimate. The dose‐response analysis indicated that the summary odds of DM for an increment of one time of tooth brushing per day was 1.20 (95% CI, 1.16‐1.24). Conclusions Integrated epidemiological evidence supports the hypothesis that low frequency of tooth brushing may be a risk factor of DM, and lower frequencies of tooth brushing were significantly associated with higher risk of DM.