Dentists may be able to play a role in identifying undiagnosed diabetes based on factors like missing teeth and periodontal (gum) disease, according to a new study published in the Journal of the American Dental Association.
Researchers have long known about a connection between diabetes and oral health — a link that may run in both directions. In other words, people with poor oral health may be more likely to develop diabetes, and people with diabetes may be more likely to develop dental problems and oral health conditions like periodontal disease. But there hasn’t been much published research looking at how oral or dental problems might be used to help identify diabetes, or how dentists could play a role in diabetes screening.
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For the latest study, researchers looked at 7,343 participants who took part in a larger study on the risk for atherosclerosis (buildup of fatty deposits in blood vessels). None of these participants reported having diabetes, but the researchers determined who actually had undiagnosed diabetes based on either a fasting glucose level of 126 mg/dl or higher, or a nonfasting glucose level above 200 mg/dl. The researchers then looked at factors related to oral health — along with the well known diabetes risk factor of obesity — to determine whether they could help predict diabetes among these participants.
The researchers found that overall, the rate of undiagnosed diabetes was 5.6%. But among participants with both obesity and edentulism (significant loss of teeth), the rate of undiagnosed diabetes was 12.6% — more than twice as high. Among those with obesity and severe periodontal disease, the rate of undiagnosed diabetes was 12.2%. When looking just at severe periodontal disease, the researchers found that people with this condition were 78% more likely to have undiagnosed diabetes, while people with edentulism were either 87% or 70% more likely to have undiagnosed diabetes, depending on the scoring system used to determine edentulism.
The study authors noted that while obesity, tooth loss, and periodontal disease could help dentists identify people at increased risk for diabetes, “Patients without these characteristics still have [undiagnosed diabetes], so dentists performing chairside diabetes screening for all patients would yield additional benefit.” Right now, of course, diabetes screening isn’t a part of routine dental care — and more studies and official recommendations would be needed before such a system could be put in place. But this study shows that for at least some people at higher-than-average risk for diabetes, a screening protocol for dentists could help identify people with diabetes who might otherwise slip through the cracks of the health care system.
Want to learn more about keeping your mouth healthy with diabetes? Read “Diabetes and Dental Care,” “Four Ways to Improve Your Oral Health,” and “Practice Good Oral Health for Diabetes.”