{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:06Z","timestamp":1787018106739,"version":"build-2736575974"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,8,15]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">To evaluate the association of dental diseases and oral hygiene care with incidence of heart failure (HF) among patients with type 2 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      This study included 173\u2009927 patients with type 2 diabetes aged \u226540\u2009years, who underwent Korean National Health Insurance Service health examinations in 2008 and were followed up until the end of 2017. Hazard ratios (HRs) and 95% CIs for HF were estimated using multivariable Cox proportional hazards regression analysis. During a median follow\u2010up of 9.3\u2009years, 1.94% of participants developed HF. An increased number of missing teeth was associated with a higher risk of HF (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). HRs of HF increased among individuals with \u226515 missing teeth (HR, 1.37 [95% CI, 1.14\u20131.64]) compared with those without missing teeth. Decreased risk of HF was observed in individuals with \u22651 time\/year of professional dental cleaning (HR, 0.93 [95% CI, 0.87\u20130.99]) and in those with \u22652 times\/d of toothbrushing (HR, 0.90 [95% CI, 0.82\u20130.98]) compared with those without these practices. While combined presence of missing teeth and periodontal disease (\n                      <jats:italic>P<\/jats:italic>\n                      =0.004) or dental caries (\n                      <jats:italic>P<\/jats:italic>\n                      =0.007) increased HF risk, combined oral hygiene care was associated with further HF risk reduction (\n                      <jats:italic>P<\/jats:italic>\n                      =0.024). Better oral hygiene care was associated with decreased HF risk, even as the number of missing teeth increased (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among patients with type 2 diabetes, dental diseases and oral hygiene care are important determinants of HF development. Dental disease management and good oral care may prevent HF in patients with type 2 diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.122.029207","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T05:38:26Z","timestamp":1691386706000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Association of Dental Diseases and Oral Hygiene Care With the Risk of Heart Failure in Patients With Type 2 Diabetes: A\u00a0Nationwide Cohort Study"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8899-9637","authenticated-orcid":false,"given":"Youn","family":"Huh","sequence":"first","affiliation":[{"name":"Department of Family Medicine Uijeongbu Eulji Medical Center Eulji University Uijeongbu Gyeonggi\u2010do Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8344-6291","authenticated-orcid":false,"given":"Jung Eun","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Healthcare System Gangnam Center Seoul National University Hospital Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0612-2562","authenticated-orcid":false,"given":"Sang\u2010Hyun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics College of Medicine The Catholic University of Korea Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyungdo","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Statistics and Actuarial Science Soongsil University Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1957-2928","authenticated-orcid":false,"given":"Seon Mee","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Korea University Guro Hospital Korea University College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9514-2401","authenticated-orcid":false,"given":"Hye Soon","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2521-3064","authenticated-orcid":false,"given":"Kyung Hwan","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Korea University Anam Hospital Korea University College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6978-5342","authenticated-orcid":false,"given":"Jin\u2010Soo","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Dental Biomaterials Science and Dental Research Institute School of Dentistry Seoul National University Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4243-788X","authenticated-orcid":false,"given":"Sang Ho","family":"Jun","sequence":"additional","affiliation":[{"name":"Department of Oral &amp; 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