{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T01:39:16Z","timestamp":1789954756416,"version":"4.0.1"},"reference-count":32,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2019,1,25]],"date-time":"2019-01-25T00:00:00Z","timestamp":1548374400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004012","name":"Jane and Aatos Erkko Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004012","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100010600","name":"Tampere University Hospital","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100010600","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002341","name":"Academy of Finland","doi-asserted-by":"crossref","award":["286284"],"award-info":[{"award-number":["286284"]}],"id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Laboratory Medicine Foundation"},{"name":"Finnish Clinical Chemistry Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The objective of this study was to investigate the association of tooth brushing frequency and bacterial communities of gingival crevicular fluid in patients subjected to preoperative dental examination prior to operative treatment for unruptured intracranial aneurysms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Gingival crevicular fluid samples were taken from their deepest gingival pocket from a series of hospitalized neurosurgical patients undergoing preoperative dental screening (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a060). The patients were asked whether they brushed their teeth two times a day, once a day, or less than every day. Total bacterial DNA was isolated and the V3\u2013V4 region of the 16S rRNA gene was amplificated. Sequencing was performed with Illumina\u2019s 16S metagenomic sequencing library preparation protocol and data were analyzed with QIIME (1.9.1) and R statistical software (3.3.2).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Bacterial diversity (Chao1 index) in the crevicular fluid reduced along with reported tooth brushing frequency (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0002;\n                      <jats:italic>R<\/jats:italic>\n                      2\u00a0=\u00a034%;\n                      <jats:italic>p<\/jats:italic>\n                      (adjusted with age and sex) = 0.09;\n                      <jats:italic>R<\/jats:italic>\n                      2\u00a0=\u00a011%) showing that patients who reported brushing their teeth twice a day had the lowest bacterial diversity. According to the differential abundant analysis between the tooth brushing groups, tooth brushing associated with two phyla of fusobacteria [\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0001;\u00a0\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0007], and one bacteroidetes (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.004) by reducing their amounts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tooth brushing may reduce the gingival bacterial diversity and the abundance of periodontal bacteria maintaining oral health and preventing periodontitis, and thus it is highly recommended for neurosurgical patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.6316","type":"journal-article","created":{"date-parts":[[2019,1,25]],"date-time":"2019-01-25T04:13:27Z","timestamp":1548389607000},"page":"e6316","source":"Crossref","is-referenced-by-count":19,"title":["Increased tooth brushing frequency is associated with reduced gingival pocket bacterial diversity in patients with intracranial aneurysms"],"prefix":"10.7717","volume":"7","author":[{"given":"Mikko J.","family":"Pyysalo","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland"},{"name":"Department of Oral and Maxillofacial diseases, Tampere University Hospital, Tampere, Finland"},{"name":"Oral Health Services, City of Tampere, Tampere, Finland"},{"name":"Department of Molecule Microbiology, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pashupati P.","family":"Mishra","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology and Finnish Cardiovascular Research Center, University of Tampere, Tampere, Finland"},{"name":"Fimlab Laboratories ltd, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kati","family":"Sundstr\u00f6m","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology and Finnish Cardiovascular Research Center, University of Tampere, Tampere, Finland"},{"name":"Fimlab Laboratories ltd, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terho","family":"Lehtim\u00e4ki","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology and Finnish Cardiovascular Research Center, University of Tampere, Tampere, Finland"},{"name":"Fimlab Laboratories ltd, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pekka J.","family":"Karhunen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology and Finnish Cardiovascular Research Center, University of Tampere, Tampere, Finland"},{"name":"Fimlab Laboratories ltd, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Pessi","sequence":"additional","affiliation":[{"name":"Department of Molecule Microbiology, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4443","published-online":{"date-parts":[[2019,1,25]]},"reference":[{"issue":"Suppl 1","key":"10.7717\/peerj.6316\/ref-1","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.1186\/s12864-016-3254-5","article-title":"Integrated metagenomic data analysis demonstrates that a loss of diversity in oral microbiota is associated with periodontitis","volume":"18","author":"Ai","year":"2017","journal-title":"BMC Genomics"},{"issue":"15","key":"10.7717\/peerj.6316\/ref-2","doi-asserted-by":"publisher","first-page":"2114","DOI":"10.1093\/bioinformatics\/btu170","article-title":"Trimmomatic: a flexible trimmer for Illumina sequence data","volume":"30","author":"Bolger","year":"2014","journal-title":"Bioinformatics"},{"issue":"11","key":"10.7717\/peerj.6316\/ref-3","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1111\/j.1600-051X.2011.01775.x","article-title":"Periodontitis is associated with angiographically verified coronary artery disease","volume":"38","author":"Buhlin","year":"2011","journal-title":"Journal of Clinical Periodontology"},{"issue":"5","key":"10.7717\/peerj.6316\/ref-4","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1038\/nmeth.f.303","article-title":"QIIME allows analysis of high-throughput community sequencing data","volume":"7","author":"Caporaso","year":"2010","journal-title":"Nature Methods"},{"issue":"Suppl 1","key":"10.7717\/peerj.6316\/ref-5","doi-asserted-by":"publisher","first-page":"4516","DOI":"10.1073\/pnas.1000080107","article-title":"Global patterns of 16S rRNA diversity at a depth of millions of sequences per sample","volume":"108","author":"Caporaso","year":"2011","journal-title":"Proceedings of the National Academy of Sciences of the United States of America"},{"key":"10.7717\/peerj.6316\/ref-6","first-page":"265","article-title":"Nonparametric estimation of the number of classes in a population","volume":"11","author":"Chao","year":"1984","journal-title":"Scandinavian Journal of Statistics"},{"issue":"2","key":"10.7717\/peerj.6316\/ref-7","first-page":"95","article-title":"Using DGGE and 16S rRNA gene sequence analysis to evaluate changes in oral bacterial composition","volume":"14","author":"Chen","year":"2011","journal-title":"Chinese Journal of Dental Research"},{"key":"10.7717\/peerj.6316\/ref-8","doi-asserted-by":"publisher","first-page":"baq013","DOI":"10.1093\/database\/baq013","article-title":"The human oral microbiome database: a web accessible resource for investigating oral microbe taxonomic and genomic information","volume":"2010","author":"Chen","year":"2010","journal-title":"Database"},{"issue":"9","key":"10.7717\/peerj.6316\/ref-9","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.1902\/jop.2009.090185","article-title":"Comparisons of subgingival microbial profiles of refractory periodontitis, severe periodontitis, and periodontal health using the human oral microbe identification microarray","volume":"80","author":"Colombo","year":"2009","journal-title":"Journal of Periodontology"},{"issue":"5","key":"10.7717\/peerj.6316\/ref-10","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1161\/01.CIR.0000154582.37101.15","article-title":"Periodontal microbiota and carotid intima-media thickness: the oral infections and vascular disease epidemiology study (INVEST)","volume":"111","author":"Desvarieux","year":"2005","journal-title":"Circulation"},{"issue":"2","key":"10.7717\/peerj.6316\/ref-11","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1139\/cjm-2014-0565","article-title":"Microbial diversity of the supra- and subgingival biofilm of healthy individuals after brushing with chlorhexidine- or silver-coated toothbrush bristles","volume":"61","author":"Do\u00a0Nascimento","year":"2015","journal-title":"Canadian Journal of Microbiology"},{"issue":"9","key":"10.7717\/peerj.6316\/ref-12","doi-asserted-by":"publisher","first-page":"2761","DOI":"10.1128\/JCM.01228-07","article-title":"16S rRNA gene sequencing for bacterial identification in the diagnostic laboratory: pluses, Perils, and Pitfalls","volume":"45","author":"Janda","year":"2007","journal-title":"Journal of Clinical Microbiology"},{"key":"10.7717\/peerj.6316\/ref-13","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1111\/j.1600-0757.2006.00187.x","article-title":"Bacterial interactions and successions during plaque development","volume":"42","author":"Kolenbrander","year":"2006","journal-title":"Periodontol 2000"},{"key":"10.7717\/peerj.6316\/ref-14","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1111\/prd.12016","article-title":"Microbiology of aggressive periodontitis","volume":"65","author":"Kononen","year":"2014","journal-title":"Periodontol 2000"},{"issue":"8","key":"10.7717\/peerj.6316\/ref-15","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1177\/0022034515586352","article-title":"Missing teeth predict incident cardiovascular events, diabetes and death","volume":"94","author":"Liljestrand","year":"2015","journal-title":"Journal of Dental Research"},{"issue":"12","key":"10.7717\/peerj.6316\/ref-16","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1186\/s13059-014-0550-8","article-title":"Moderated estimation of fold change and dispersion for RNA-seq data with DESeq2","volume":"15","author":"Love","year":"2014","journal-title":"Genome Biology"},{"key":"10.7717\/peerj.6316\/ref-17","volume-title":"Oral microbiology","author":"Marsh","year":"2009","edition":"5"},{"issue":"4","key":"10.7717\/peerj.6316\/ref-18","doi-asserted-by":"publisher","first-page":"e61217","DOI":"10.1371\/journal.pone.0061217","article-title":"phyloseq: an R package for reproducible interactive analysis and graphics of microbiome census data","volume":"8","author":"McMurdie","year":"2013","journal-title":"PLOS ONE"},{"issue":"3","key":"10.7717\/peerj.6316\/ref-19","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1128\/AEM.59.3.695-700.1993","article-title":"Profiling of complex microbial populations by denaturing gradient gel electrophoresis analysis of polymerase chain reaction-amplified genes coding for 16S rRNA","volume":"59","author":"Muyzer","year":"1993","journal-title":"Applied and Environmental Microbiology"},{"key":"10.7717\/peerj.6316\/ref-20","doi-asserted-by":"publisher","first-page":"16004","DOI":"10.1038\/npjbiofilms.2016.4","article-title":"A perspective on 16S rRNA operational taxonomic unit clustering using sequence similarity","volume":"2","author":"Nguyen","year":"2016","journal-title":"NPJ Biofilms Microbiomes"},{"key":"10.7717\/peerj.6316\/ref-21","doi-asserted-by":"publisher","first-page":"1108","DOI":"10.1086\/512818","article-title":"Detection and identification of microorganisms by gene amplification and sequencing","volume":"44","author":"Petti","year":"2007","journal-title":"Clinical Infectious Diseases"},{"issue":"4","key":"10.7717\/peerj.6316\/ref-22","doi-asserted-by":"publisher","first-page":"315","DOI":"10.3109\/00016357.2015.1130854","article-title":"Bacterial DNA findings in ruptured and unruptured intracranial aneurysms","volume":"74","author":"Pyysalo","year":"2016","journal-title":"Acta Odontologica Scandinavica"},{"issue":"11","key":"10.7717\/peerj.6316\/ref-23","doi-asserted-by":"publisher","first-page":"1214","DOI":"10.1136\/jnnp-2012-304635","article-title":"The connection between ruptured cerebral aneurysms and odontogenic bacteria","volume":"84","author":"Pyysalo","year":"2013","journal-title":"Journal of Neurology, Neurosurgery and Psychiatry"},{"key":"10.7717\/peerj.6316\/ref-24","article-title":"R: a language and environment for statistical computing","author":"R Core Team","year":"2013"},{"key":"10.7717\/peerj.6316\/ref-25","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1034\/j.1600-0757.2002.280102.x","article-title":"Dental biofilms: difficult therapeutic targets","volume":"28","author":"Socransky","year":"2002","journal-title":"Periodontol 2000"},{"issue":"2","key":"10.7717\/peerj.6316\/ref-26","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1111\/j.1600-051X.1998.tb02419.x","article-title":"Microbial complexes in subgingival plaque","volume":"25","author":"Socransky","year":"1998","journal-title":"Journal of Clinical Periodontology"},{"issue":"4","key":"10.7717\/peerj.6316\/ref-27","first-page":"152","article-title":"Taxonomic parameters revisited: tarnished gold standards","volume":"33","author":"Stackebrandt","year":"2006","journal-title":"Microbiology Today"},{"key":"10.7717\/peerj.6316\/ref-28","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.ics.2005.06.071","article-title":"Microbial ecosystem in the oral cavity: metabolic diversity in an ecological niche and its relationship with oral diseases","volume":"1284","author":"Takahashi","year":"2005","journal-title":"International Congress Series"},{"issue":"8","key":"10.7717\/peerj.6316\/ref-29","doi-asserted-by":"publisher","first-page":"e105592","DOI":"10.1371\/journal.pone.0105592","article-title":"Development of a prokaryotic universal primer for simultaneous analysis of Bacteria and Archaea using next-generation sequencing","volume":"9","author":"Takahashi","year":"2014","journal-title":"PLOS ONE"},{"key":"10.7717\/peerj.6316\/ref-30","doi-asserted-by":"publisher","first-page":"22164","DOI":"10.1038\/srep22164","article-title":"Bacterial diversity in saliva and oral health-related conditions: the Hisayama study","volume":"6","author":"Takeshita","year":"2016","journal-title":"Scientific Reports"},{"issue":"Suppl 14","key":"10.7717\/peerj.6316\/ref-31","doi-asserted-by":"publisher","first-page":"S24","DOI":"10.1902\/jop.2013.1340019","article-title":"Periodontitis and atherosclerotic cardiovascular disease consensus report of the joint EFP\/AAP workshop on periodontitis and systemic disease","volume":"40","author":"Tonetti","year":"2013","journal-title":"Journal of Clinical Periodontology"},{"issue":"5","key":"10.7717\/peerj.6316\/ref-32","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1189\/jlb.4A1115-526RR","article-title":"Platelet activation and platelet-leukocyte interaction in generalized aggressive periodontitis","volume":"100","author":"Zhan","year":"2016","journal-title":"Journal of Leukocyte Biology"}],"container-title":["PeerJ"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/peerj.com\/articles\/6316.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/6316.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/6316.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/6316.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,23]],"date-time":"2020-11-23T19:03:05Z","timestamp":1606158185000},"score":1,"resource":{"primary":{"URL":"https:\/\/peerj.com\/articles\/6316"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,25]]},"references-count":32,"alternative-id":["10.7717\/peerj.6316"],"URL":"https:\/\/doi.org\/10.7717\/peerj.6316","archive":["CLOCKSS","LOCKSS","Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.7287\/peerj.6316v0.1\/reviews\/1","asserted-by":"object"},{"id-type":"doi","id":"10.7287\/peerj.6316v0.1\/reviews\/2","asserted-by":"object"},{"id-type":"doi","id":"10.7287\/peerj.6316v0.3\/reviews\/2","asserted-by":"object"},{"id-type":"doi","id":"10.7287\/peerj.6316v0.2\/reviews\/2","asserted-by":"object"},{"id-type":"doi","id":"10.7287\/peerj.6316v0.2\/reviews\/1","asserted-by":"object"}]},"ISSN":["2167-8359"],"issn-type":[{"value":"2167-8359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,25]]},"article-number":"e6316"}}