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. 2024 Feb 2;14(1):2777.
doi: 10.1038/s41598-024-53213-x.

Effects of mouthwash on periodontal pathogens and glycemic control in patients with type 2 diabetes mellitus

Saaya Matayoshi  1 , Fumikazu Tojo  2 , Yuto Suehiro  2 , Makoto Okuda  2 , Misato Takagi  2 , Marin Ochiai  2 , Maika Kadono  2 , Yusuke Mikasa  2 , Rena Okawa  3   2 , Ryota Nomura  4 , Yoshito Itoh  5   6 , Naoto Itoh  3   5 , Kazuhiko Nakano  3   2
Affiliations

Effects of mouthwash on periodontal pathogens and glycemic control in patients with type 2 diabetes mellitus

Saaya Matayoshi et al. Sci Rep. .

Abstract

Periodontitis is known to be associated with type 2 diabetes mellitus (T2DM), and gargling with mouthwash is known to reduce the incidence of periodontitis by inhibiting periodontal pathogens. However, the effects of mouthwash on oral and systemic conditions in patients with T2DM remain unknown. In this study, we investigated the effects of gargling with mouthwash on the number of red complex species, including Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, and HbA1c levels in patients with T2DM. Patients were instructed to gargle with water for 6 months, followed by gargling with mouthwash containing chlorhexidine gluconate for the subsequent 6 months. At each clinic visit, saliva was collected and bacterial DNA was extracted to detect red complex species using the polymerase chain reaction technique. The HbA1c level was determined using a blood sample. The number of red complex species significantly decreased in younger or male patients who gargled with mouthwash. Furthermore, HbA1c levels significantly decreased in younger patients or patients with higher HbA1c levels who gargled with mouthwash. These results suggest that gargling with mouthwash reduces the number of red complex species and improves the hyperglycemic status in patients with T2DM, especially younger patients.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flowchart of patient selection. BMI body mass index.
Figure 2
Figure 2
The time course of a remarkably effective case in this study. Chronological changes in the number of major periodontopathic bacterial species and red complex species (A) and HbA1c level (B). Time points for analysis were the start of water gargling, the end of water gargling, the start of mouthwash gargling, and the end of mouthwash gargling.
Figure 3
Figure 3
Comparison of the number of red complex species as a function of gargling frequency. Significant differences were observed using analysis of variance with Bonferroni correction (***P < 0.001).
Figure 4
Figure 4
Comparison of the number of red complex species and HbA1c levels. (A) Number of red complex species. (B) HbA1c levels. (C) Seasonal variation of HbA1c levels. (D) HbA1c levels after excluding seasonal variation. Significant differences were observed using analysis of variance with Bonferroni correction (**P < 0.01, ***P < 0.001).
Figure 5
Figure 5
Comparison of changes in the number of red complex species as a function of clinical factors. (A) Age, (B) baseline HbA1c level, (C) sex, (D) disease duration, and (E) baseline BMI. Significant differences were observed using Student’s t-test (*P < 0.05).
Figure 6
Figure 6
Comparison of changes in the HbA1c levels as a function of clinical factors. (A) Age, (B) baseline HbA1c level, (C) sex, (D) disease duration, and (E) baseline BMI. Significant differences were observed using Student’s t-test (*P < 0.05).
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