Journal of Korean Dental Hygiene Science (대한치위생과학회지)

The Korean Academy of Dental Hygiene & The Korean Society of Dental Hygiene Science (대한치과위생학회 & 한국치위생과학회)
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Association between the usage of dental floss and interdental brushes and the prevalence of systemic diseases

치실 및 치간칫솔 사용과 전신질환 유병률의 연관성

  • Seon-Jip Kim (Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University) ;
  • Hye-Jin Kwon (Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University) ;
  • Hyun-Jae Cho (Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University)
  • 김선집 (서울대학교 치의학대학원 예방치학교실) ;
  • 권혜진 (서울대학교 치의학대학원 예방치학교실) ;
  • 조현재 (서울대학교 치의학대학원 예방치학교실)
  • Received : 2024.06.07
  • Accepted : 2024.06.18
  • Published : 2024.06.30
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Abstract

Background: Oral health has a significant impact on systemic health, and the close association between oral and systemic diseases has been continuously reported. To prevent oral diseases, the role of oral hygiene products such as dental floss and interdental brushes, in addition to tooth brushing, is becoming increasingly important. This study aims to analyze the effect of using oral hygiene products on the lifetime prevalence of systemic diseases among Korean adults. Methods: This study utilized data from the 7th Korea National Health and Nutrition Examination Survey (2016-2018). The study population consisted of 13,199 adults aged 19 years and older. The independent variable was the use of oral hygiene products, and the dependent variable was the prevalence of systemic diseases diagnosed by a physician. Demographic variables, health status, and behavioral variables were included as covariates, and multivariable logistic regression analysis was performed. Results: The use of dental floss showed no significant association with the prevalence of systemic diseases. However, those who did not use interdental brushes had a 22% lower likelihood of dyslipidemia (OR 0.777, 95% CI 0.660-0.913). Among participants with periodontal disease, those who did not use dental floss had a significantly higher risk of myocardial infarction (OR 11.488, 95% CI 1.438-91.772). Conversely, those who did not use interdental brushes had lower risks of dyslipidemia, myocardial infarction, and angina, particularly among women and individuals under 65 years of age. Conclusion: This study found a low overall association between the use of oral hygiene products and the prevalence of systemic diseases, but there was a notable association with cardiovascular diseases. To reduce the risk of myocardial infarction, the prevention and treatment of periodontal disease, along with proper oral hygiene management, are crucial. Future prospective studies are needed to clearly establish the causal relationship between oral hygiene and systemic diseases.

연구 배경 : 구강건강은 전신건강에 중요한 영향을 미치며, 구강질환과 전신질환 간의 밀접한 연관성은 현재까지 지속적으로 보고되고 있다. 특히 치주질환은 심혈관질환, 당뇨병, 호흡기 질환 등 다양한 만성질환과 관련이 있다. 구강질환 예방을 위해 칫솔질뿐만 아니라 치실과 치간칫솔 등의 구강관리용품의 역할이 중요해지고 있다. 본 연구는 구강관리용품 사용이 한국 성인의 전신질환 유병률에 미치는 영향을 분석하고자 한다. 연구 방법 : 본 연구는 국민건강영양조사 제7기(2016-2018) 데이터를 활용하였다. 연구대상자는 만 19세 이상의 성인 13,199명으로 구성되었다. 독립변수는 구강관리용품 사용 여부로 정의하였으며, 종속변수는 의사 진단에 의한 전신질환 이환 여부로 설정하였다. 인구통계학적 변수, 건강 상태 및 행태 변수를 공변량으로 포함하여 다변량 로지스틱 회귀분석을 수행하였다. 결과 : 치실 사용 여부는 전신질환 이환과 유의미한 관련성을 보이지 않았다. 그러나 치간칫솔 미사용자는 이상지질혈증 이환 가능성이 22% 낮았다(OR 0.777, 95% CI 0.660-0.913). 치주질환이 있는 대상자 중 치실을 사용하지 않는 경우 심근경색 위험이 유의미하게 높았다(OR 11.488, 95% CI 1.438-91.772). 반면, 치간칫솔 미사용자는 여성과 65세 미만 대상자에서 이상지질혈증, 심근경색 및 협심증의 위험이 낮았다. 결론 : 본 연구는 구강관리용품 사용이 전반적인 전신질환 이환과의 연관성이 낮아 보이나, 심혈관계 질환과의 연관성은 확인할 수 있었다. 특히 심근경색의 위험도를 낮추기 위해서는 치주질환 예방 및 치료와 함께 구강위생관리가 중요하다. 향후 전향적 연구를 통해 구강건강과 전신질환 간의 인과관계를 명확히 규명할 필요가 있다.

Keywords

Acknowledgement

이 성과는 정부(과학기술정보통신부)의 재원으로 한국연구재단의 지원을 받아 수행된 연구임(No. 2020R1C1C1013322).

References

  1. Lee KH. Influential factors for the use of oral hygiene supplies in metropolitan area. J Kor Soc Dent Hyg 2013;13(6):951-959. https://doi.org/10.13065/jksdh.2013.13.06.951 
  2. Slavkin HC, Baum BJ. Relationship of dental and oral pathology to systemic illness. Jama 2000;284(10):1215-1217. https://doi.org/10.1001/jama.284.10.1215 
  3. Shin HS, et al. Association between the number of existing permanent teeth and chronic obstructive pulmonary disease. J Dent Hyg Sci 2016;16(3):217-224. https://doi.org/10.17135/jdhs.2016.16.3.217 
  4. Bahekar AA, et al. The prevalence and incidence of coronary heart disease is significantly increased in periodontitis: a meta-analysis. Am Heart J 2007;154(5):830-837. https://doi.org/10.1016/j.ahj.2007.06.037 
  5. Kang HJ. A study on periodontal disease and tooth loss in metabolic syndrome patient. J Dent Hyg Sci 2015;15(4):445-456. http://doi.org/10.17135/jdhs.2015.15.4.445 
  6. Park ES, Choi JS. The effect of health status on general quality of life and oral health related quality of life in the middle-aged adults. J Dent Hyg Sci 2012;12(6):624-633. 
  7. Arigbede AO, et al. Periodontitis and systemic diseases: A literature review. J Indian Soc Periodontol 2012;16(4):487-491. https://doi.org/10.4103/0972-124X.106878 
  8. Nam YO, Kim IJ. Association between two major oral diseases and cardiovascular diseases. J Kor Soc Dent Hyg 2018;18(5):653-664. http://dx.doi.org/10.13065/jksdh.20180056 
  9. Parameter on periodontitis associated with systemic conditions. American Academy of Periodontology. J Periodontol 2000; 71(5 Suppl): 876-879. https://doi.org/10.1902/jop.2000.71.5-S.876 
  10. Kim SK. A study on the status of recognition and practical application of oral hygiene devices: with outpatient as the central figure. J Dent Hyg Sci 2002;2(2):95-103. 
  11. Seo EJ, et al. A survey on Koreans' behavior about the use of oral hygiene devices. J Korean Acad Dent Health 2003;27(2):177-193. 
  12. Han SJ. Association between needs for scaling and oral and general health behaviors in middle-aged people. Journal of the Korea Convergence Society 2020;11(5):51-59. http://dx.doi.org/10.15207/JKCS.2020.11.5.051 
  13. Jung GO. A survey about the use of oral hygiene device and awareness especially for the group of people who are aged from 30 to 50 in Daegu and Kyungbuk. J Kor Soc Dent Hyg 2009;9(4):1-17. 
  14. Yoon HS. A study on knowledge and use of oral hygiene devices among adults. J Kor Soc Dent Hyg 2009;9(3):339-344. 
  15. Lee KH, Jung ES. Effects of edcuation about dental hygiene devices on their use. Journal of digital Convergence 2015;13(2):245-256. http://dx.doi.org/10.14400/JDC.2015.13.2.245 
  16. Park SY, Lee HS. Use and educational needs of auxiliary oral care products in a large enterprise employees. J Kor Soc Dent Hyg 2014;14(2):223-230. http://dx.doi.org/10.13065/jksdh.2014.14.02.223 
  17. Han SJ. Evaluation of the association between dental floss and interdental brush use and periodontal health inequality reduction: among Korean adults. J Korean Soc Dent Hyg 2021;21(2):129-140. http://dx.doi.org/10.13065/jksdh.20210013 
  18. Zimmer S, et al. Clinical efficacy of flossing versus use of antimicrobial rinses. J periodontol 2006;77(8):1380-1385. https://doi.org/10.1902/jop.2006.050362 
  19. Goyal CR, et al. Evaluation of the plaque removal efficacy of a water flosser compared to string floss in adults after a single use. J Clin Dent 2013;24(2):37-42. 
  20. Salas M, et al. Interproximal cervical lesions caused by incorrect flossing technique. Int J Dent Hyg 2012;10(2):83-85. https://doi.org/10.1111/j.1601-5037.2011.00524.x 
  21. Arora V, et al. Efficacy of dental floss and chlorhexidine mouth rinse as an adjunct to toothbrushing in removing plaque and gingival inflammation-A three way cross over trial. J Clin Diagn Res 2014;8(10):ZC01-4. https://doi.org/10.7860/JCDR/2014/8807.4943 
  22. Rosing CK, et al. Efficacy of interdental plaque control aids in periodontal maintenance patients: A comparative study. Oral Health Prev Dent 2006;4(2):99-103. 
  23. Imai PH, et al. Comparison of interdental brush to dental floss for reduction of clinical parameters of periodontal disease: A systematic review. Can J Dent H yg 2012;46(1):63-78. 
  24. Lee JY, et al. The use of an interdental brush mitigates periodontal health inequalities: the Korean National Health and nutrition examination survey (KNHANES). BMC Oral Health 2019;19:1-8. https://doi.org/10.1186/s12903-019-0858-6 
  25. Lee YH, et al. A survey on family dental health behavior in Seoul capital city. J Korean Acad Dent Health 2000;24(3):239-254. 
  26. Kim JY, Jung GO. The awareness of oral health treatment and use of present in dental patients. J Dent Hyg Sci 2009;15(2):61-70. 
  27. Paik DI. Knowledge, attitude, and practices about dental caries among Koreans. J Korean Acad Dent Health 1993;17(1):1-12. 
  28. Park HR. A study on the status of practical application of oral hygiene devices: with labor of the D heavy industries. J Dent Hyg Sci 2006;6(2):93-99. 
  29. Toyama T, et al. Dental floss use among elementary school children and environmental factors; a cross-sectional study. Pediatric Dent J2019;29(2):78-83. https://doi.org/10.1016/j.pdj.2019.04.003 
  30. Arcaya MC, et al. Inequalities in health: definitions, concepts, and theories. Glob Health Action 2015;8:27106. https://doi.org/10.3402/gha.v8.27106 
  31. Larkin M. Can flossing teeth foil heart disease? Lancet 2002;360(9327):147. https://doi.org/10.1016/S0140-6736(02)09442-4 
  32. Lockhart PB, et al. Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association?: a scientific statement from the American Heart Association. Circulation 2012;125(20):2520-2544. https://doi.org/10.1161/CIR.0b013e31825719f3 
  33. Lavigne SE, Forrest JL. An umbrella review of systematic reviews of the evidence of a causal relationship between periodontal disease and cardiovascular diseases: Position paper from the Canadian Dental Hygienists Association. Can J Dent Hyg 2020;54(1):32-41. 
  34. Etta I, et al. Mouth-Heart Connection: A Systematic Review on the Impact of Periodontal Disease on Cardiovascular Health. Cureus 2023;15(10):e46585. https://doi.org/10.7759/cureus.46585 
  35. Ajwani S, et al. Periodontal disease and mortality in an aged population. Spec Care Dentist 2003;23(4):125-130. https://doi.org/10.1111/j.1754-4505.2003.tb00297.x 
  36. Beck J, et al. Periodontal disease and cardiovascular disease. J Periodontol 1996;67(10 Suppl):1123-1137. https://doi.org/10.1902/jop.1996.67.10s.1123 
  37. Worthington HV, et al. Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal diseases and dental caries. Cochrane Database Syst Rev 2019;4(4):Cd012018. https://doi.org/10.1002/14651858.CD012018.pub2 
  38. Yu B, Wang CY. Osteoporosis and periodontal diseases-An update on their association and mechanistic links. Periodontol 2000 2022;89(1):99-113. https://doi.org/10.1111/prd.12422 
  39. Zahid TM, et al. The effects of thyroid hormone abnormalities on periodontal disease status. J Int Acad Periodontol 2011;13(3):80-85. 
  40. Pathak JL, et al. The role of oral microbiome in respiratory health and diseases. Respir Med 2021;185:106475. https://doi.org/10.1016/j.rmed.2021.106475 
  41. Wang Z, et al. Periodontal health, oral health behaviours, and chronic obstructive pulmonary disease. J Clin Periodontol 2009;36(9):750-755. https://doi.org/10.1111/j.1600-051X.2009.01448.x 
  42. Liu Z, et al. Oral hygiene, periodontal health and chronic obstructive pulmonary disease exacerbations. J Clin Periodontol 2012;39(1):45-52. https://doi.org/10.1111/j.1600-051X.2011.01808.x 
  43. Charlson ME, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987;40(5):373-383. https://doi.org/10.1016/0021-9681(87)90171-8