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Modern global practices place special emphasis on perioperative care as the number of elderly patients with accompanying illnesses increases. Additionally, surgical interventions are becoming more complex, with a growing number of previously inoperable conditions now being treated surgically. Lately, the importance of perioperative oral cavity care has increased. It is recommended for patients with malignant tumors, lung diseases, gastrointestinal disorders, and cardiovascular diseases (CVD). Several reports indicate that postoperative oral cavity care has a positive impact on cardiovascular surgery outcomes. However, these reports have not explored the relationship between toothbrushing time and systemic diseases, including CVD.
Research Methodology
The study involved 1,583 individuals aged ≥ 20 years. All of them were hospitalized at Osaka University Hospital between April 2013 and March 2016 and visited its dental department.
The patients were divided into four groups: “MN” (brushed teeth in the morning and at night – 409 individuals, 25.8%); “M” (brushed teeth only in the morning – 164 people, 10.4%); “Night” (brushed teeth only at night – 751 individuals, 47.4%); and the “None” group (never brushed teeth at all – 259 patients, 16.4%).
The researchers assessed the age, gender, harmful habits, including smoking, and the subsequent observation results of each participant. Additionally, four independent investigators retrospectively reviewed the dental and medical records of all study participants.
Next, the researchers examined cardiovascular events among the participants until the end of the observation period (June 30, 2016) or until their death. This included hospitalization due to heart failure, arrhythmia, myocardial infarction, angina pectoris, and valvular and aortic diseases requiring surgical intervention.
How Toothbrushing Time Influences the Risk of CVD Development
The “MN” and “Night” groups had significantly higher survival rates compared to the “None” group. Smokers in the “None” group had an even worse prognosis for the development of cardiovascular disorders than smokers in the other groups. Non-smokers with hospitalizations in the “None” and “MN” groups showed a worse prognosis.
The researchers acknowledge certain limitations, including the fact that all participants were hospitalized patients, which could have complicated their oral care. Additionally, they were all patients of a single hospital.
However, the researchers believe that the results are clear: brushing teeth only in the morning upon awakening is important but insufficient. Brushing teeth before bedtime is beneficial for maintaining oral health and preventing cardiovascular diseases. That aligns with the theory that oral cavity bacterial load increases during sleep at night due to reduced saliva production.
