Commentary on the association between toothbrushing behavior and cardiometabolic multimorbidity in aging populations.

This Matters arising addresses the article titled "Association between toothbrushing behavior and cardiometabolic multimorbidity among middle-aged and older adults in North China: a cross-section study", published in BMC Oral Health 24, 1333 (2024). The study investigates the association between toothbrushing behavior and cardiometabolic multimorbidity (CMM) in middle-aged and older adults, presenting valuable insights into the association between oral hygiene and CMM risk. While acknowledging its contributions to public health, the present commentary seeks to methodically identify areas that could be improved with regard to methodology and statistics. Firstly, it is recommended that more comprehensive exclusion criteria be applied to account for participants who may have conditions that could affect self-reported oral hygiene, such as psychiatric disorders or immunocompromised status. Furthermore, I propose that future studies employ a more rigorous multivariable regression model to address potential confounders collectively. This approach may help mitigate the limitations posed by wide confidence intervals, particularly within specific CMM subgroups. It should be noted that this commentary does not intend to refute or confirm the findings of the original study. Rather, our objective is to provide support for future research efforts in refining the association between oral health practices and CMM across diverse populations.