Improved diabetes control with Chlorhexidine rinse

Dr. Rajeev Chitguppi

Wed. 28 February 2024

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Researchers at Osaka University have demonstrated a promising connection between improved oral hygiene and better control of Type 2 diabetes. The study, published in Scientific Reports, suggests that regular gargling with antiseptic Chlorhexidine mouthwash could effectively reduce the pathogenic bacteria in the mouths of individuals with Type 2 diabetes, potentially leading to better blood sugar control.

The study delved into the correlation between chronic inflammation in the mouth, often associated with conditions like gum disease, and serious health issues such as Alzheimer's disease and Type 2 diabetes. The researchers aimed to find a simple yet effective method to combat bacteria linked to these problems.

The researchers investigated if using the antiseptic chlorhexidine gluconate mouthwash could reduce —Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia—the three highly virulent bacterial species associated with periodontitis, in Type 2 diabetes patients.

For a year, the researchers collected saliva and blood samples from 173 participants. The study involved six months of gargling with water followed by a subsequent six-month period with chlorhexidine mouthwash. This approach allowed the team to discern whether gargling itself or chlorhexidine mouthwash was more effective in reducing bacteria.

Results showed that gargling with water had no noticeable effects on bacterial species or blood-sugar control. However, a significant reduction in the three targeted bacterial species was observed when participants switched to chlorhexidine mouthwash, provided they gargled at least twice daily.

The researchers expressed no surprise upon finding that gargling with plain water had no effects on bacterial species or glycated hemoglobin (HbA1c) levels. However, there was an overall reduction in bacterial species when patients switched to chlorhexidine mouthwash, provided they gargled at least twice a day.

While no overall changes in HbA1c levels were observed during mouthwash use, the researchers discovered substantial variations in individual responses. Younger patients, in particular, exhibited greater reductions in bacterial species and significantly improved blood-sugar control compared to their counterparts who gargled with water.

The findings suggest that identifying individuals likely to respond well to antiseptic mouthwash could improve outcomes for those with periodontitis-linked diseases, including diabetes, dementia, cardiovascular disease, and respiratory tract infections. This easy-to-implement oral hygiene treatment could prove instrumental in enhancing the overall health of individuals with Type 2 diabetes.

Editorial note:

References

Gargling away the bad bacteria in type 2 diabetes. Osaka University research page
Matayoshi, S., Tojo, F., Suehiro, Y. et al. Effects of mouthwash on periodontal pathogens and glycemic control in patients with type 2 diabetes mellitus. Sci Rep 14, 2777 (2024). https://doi.org/10.1038/s41598-024-53213-x