Increased Risk Of Cardiovascular Disease
In recent years, the importance of perioperative oral management has increased and is recommended for patients with malignancies, pulmonary diseases, gastrointestinal diseases, and cardiovascular diseases. The association between oral management and malignancies, pulmonary diseases, and gastrointestinal diseases has been extensively reported, with the consensus that patients benefit from perioperative oral care.
Dental diseases have been associated with cardiovascular disease risk. Several reports suggest that perioperative oral care positively impacts cardiovascular surgery outcomes. Contrastingly, some reports suggest that oral hygiene is not associated with long-term prognosis in cardiovascular diseases and that people brushing their teeth more than twice a day have a greater risk of developing a cardiovascular disease than those brushing their teeth only once.
Although “brushing teeth once a day” can imply brushing teeth at night after supper or before bedtime, we encounter many middle-aged and older patients in routine clinical practice who do not brush their teeth at night but only in the morning before breakfast. Many of them perceive the mouth to be unclean in the morning and thus brush their teeth before breakfast to avoid ingesting intraoral deposits. However, having breakfast also leads to intraoral deposits, which persist throughout the day and increase the risk of periodontal disease and dental caries.
Based on our clinical experience, patients not brushing their teeth at night have one of the following backgrounds: patients (1) may consume alcohol at night and go to bed without brushing their teeth or become too lazy to brush their teeth or (2) may be too tired after work and do not have adequate time to brush their teeth. On interviewing these patients, background (1) was found to be overwhelmingly common. Based on the perspective that intraoral plaque and deposits are present throughout the day, brushing only in the morning implies poor oral hygiene. We wondered if it also affected systemic diseases apart from periodontal disease and caries.