ArticleNitric oxide : biology and chemistry2017
Over-the-counter mouthwash use and risk of pre-diabetes/diabetes.
Article in Nitric oxide : biology and chemistry, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed, 2 syntheses or guidelines pooled it, 100 citations in OpenAlex.
- Impact of Oral Hygiene Practices in Reducing Cardiometabolic Risk, Incidence, and Mortality: A Systematic Review.International journal of environmental research and public health · 2024Pooled it
- Do Changes in Oral Microbiota Correlate With Plasma Nitrite Response? A Systematic Review.Frontiers in physiology · 2019Pooled it
- Pilot randomized trial of the effect of antibacterial mouthwash on muscle contractile function in healthy young adults.PloS one · 2025Trial
- The Oral and Nasal Gateway Microbiomes: Salivaomics and Systemic Health at the Airway-Digestive Interface.Microorganisms · 2026Review
- Higher salivary nitrite is associated with improved glycemic control and insulin sensitivity in patients with type 2 diabetes.Nutrition & metabolism · 2026Article
- Drugstore or discount? A study on fluoride, pH and acidity of commercial mouthwashes in Riyadh, Saudi Arabia.Frontiers in oral health · 2026Article
- Laser Interventions for Intraoral Halitosis: A Systematic Review of Randomized Controlled Trials.Pharmaceutics · 2025Review
- Effects of Antiseptic Formulations on Oral Microbiota and Related Systemic Diseases: A Scoping Review.Antibiotics (Basel, Switzerland) · 2025Review
- Impact of public health and patient-centered prevention strategies on periodontitis and caries as causes of tooth loss in high-income countries.Periodontology 2000 · 2025Review
- The blood pressure lowering effect of beetroot juice is impaired in periodontitis and recovered after periodontal treatment.NPJ biofilms and microbiomes · 2025Article
- Nitrate reduction by salivary bacteria, glucose metabolism, and lifestyle.Journal of oral microbiology · 2025Article
- Association of over-the-counter mouthwash use with markers of nitric oxide metabolism, inflammation, and endothelial function-a cross-sectional study.Frontiers in oral health · 2025Article
- Does chlorhexidine improve periodontal health and bacterial profiles in patients with special health care needs? A systematic review and meta-analysis.Frontiers in oral health · 2025Article
- Role of oral and gut microbiomes in enterosalivary nitrate metabolism and their effects on systemic disease.Frontiers in cellular and infection microbiology · 2025Review
- Article
- Saliva, Plasma, and Multifluid Metabolomic Signatures of Periodontal Disease, Type 2 Diabetes Progression, and Markers of Glycemia and Dyslipidemia Among Puerto Rican Adults With Overweight and Obesity.Journal of the American Heart Association · 2024Article
- Effects of Mint Oils on the Human Oral Microbiome: A Pilot Study.Microorganisms · 2024Article
- Antibacterial mouthwash alters gut microbiome, reducing nutrient absorption and fat accumulation in Western diet-fed mice.Scientific reports · 2024Article
- Nitrate reduction capacity of the oral microbiota is impaired in periodontitis: potential implications for systemic nitric oxide availability.International journal of oral science · 2024Article
- The Effects of Antimicrobial Mouthwashes on Systemic Disease: What Is the Evidence?International dental journal · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 4 institutions in 2 countries.
Funding
Abstract
aimsOver-the-counter mouthwash comprises part of routine oral care for many; however, potential adverse effects of the long-term daily use have not been evaluated. Most mouthwash contain antibacterial ingredients, which could impact oral microbes critical for nitric oxide formation, and in turn predispose to metabolic disorders including diabetes. Our aim was to evaluate longitudinally the association between baseline over-the-counter mouthwash use and development of pre-diabetes/diabetes over a 3-year follow-up. MATERIALS AND
methodsThe San Juan Overweight Adults Longitudinal Study (SOALS) recruited 1206 overweight/obese individuals, aged 40-65, and free of diabetes and major cardiovascular diseases; 945 with complete follow-up data were included in the analyses. We used Poisson regression models adjusting for baseline age, sex, smoking, physical activity, waist circumference, alcohol consumption, pre-hypertension/hypertension status; time between visits was included in the models as an offset.
resultsMany participants (43%) used mouthwash at least once daily and 22% at least twice daily. Participants using mouthwash ≥ twice daily at baseline, had a significantly elevated risk of pre-diabetes/diabetes compared to less frequent users (multivariate IRR = 1.55, 95% CI: 1.21-1.99), or non-users of mouthwash (multivariate IRR = 1.49; 95% CI: 1.13-1.95). The effect estimates were similar after adding income, education, oral hygiene, oral conditions, sleep breathing disorders, diet (processed meat, fruit, and vegetable intake), medications, HOMA-IR, fasting glucose, 2hr post load glucose or CRP to the multivariate models. Both associations were also significant among never-smokers and obese individuals. Mouthwash use lower than twice daily showed no association, suggesting a threshold effect at twice or more daily.
conclusionsFrequent regular use of over-the-counter mouthwash was associated with increased risk of developing pre-diabetes/diabetes in this population.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.