Severe Gum Disease May Be Sign of Diabetes

Severe gum disease, also known as periodontitis, may be an early sign of Type 2 diabetes, according to a new study from the University of Amsterdam. Approximately 8.1 million people in the United States and 367,500 people in the Netherlands are estimated to have undiagnosed diabetes.

Gum disease has been shown to raise insulin resistance and blood sugar levels, and high blood sugar is known to worsen gum conditions. To determine whether periodontitis is an early sign of Type 2 diabetes and can help indicate who should receive diabetes screening, researchers evaluated 313 patients at a university dental clinic. Among these participants, 126 had mild-to-moderate gum disease, 78 had periodontitis, and 198 did not have gum disease. Those with periodontitis had a higher average body-mass index (BMI) than those without, but other risk factors for diabetes, such as high cholesterol and high blood pressure, were similar across the three groups.

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The investigators found that those with the most severe gum disease had the highest HbA1c levels (a measure of blood glucose control over the previous 2–3 months), averaging 6.3%, compared to 6.1% for those with mild-to-moderate gum disease and 5.7% for those with no gum disease. They also discovered that 18.1% of those with periodontitis had previously undiagnosed Type 2 diabetes, compared to 9.9% in the mild-to-moderate group and 8.5% in the group without gum disease.

Although the study does not indicate that gum disease causes Type 2 diabetes, “we show that periodontitis is an early sign of diabetes mellitus and may therefore serve as a valuable risk indicator. A dental office that treats patients with periodontitis is a suitable location for screening for diabetes,” the researchers conclude.

“Regardless of an individual’s risk for diabetes, preventing gum disease is important for all patients,” notes Damien Walmsley, PhD, MSc, BDS, FDSRCPS, who was not involved in the study. “The best way to do this is to limit sugar intake, brush teeth twice a day with fluoride toothpaste, and visit the dentist regularly to detect problems early, as many dental problems don’t become visible or cause pain until they are in more advanced stages.”

For more information, see the article “Periodontitis May Be an Early Sign of Type 2 Diabetes” or the study in the journal BMJ Open Diabetes Research & Care. And to learn more about diabetes and your mouth, read “Disease, Treatment, and Oral Health” by dental hygienist Shirley Gutkowski.

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