Worse glucose control is linked to having fewer teeth, according to a new study published in the journal Diabetology International.
There is a well established link between diabetes and oral health, with studies suggesting that there may be a two-way relationship between the two — in other words, that poor oral health may raise blood glucose levels in people with diabetes, and that poor glucose control may increase the risk for oral health problems. There is also evidence that simply reminding people with diabetes to take care of their teeth can lead to improved oral health potentially leading to better outcomes, such as a lower risk for tooth loss.
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For the latest study, researchers looked at medical records from 233,567 people ages 20 to 70 in Japan — a group that contained people with and without diabetes. As noted in a press release on the study, participants were divided into five groups based on their A1C level (a measure of long-term blood glucose control) and three different groups based on their fasting glucose level. The five groups for A1C were based on the following measurements — less than 5.5%, 5.5-6.4%, 6.5-7.4%, 7.5-8.4%, and 8.5% or higher. The three groups for fasting blood glucose were based on the following measurements — less than 110 mg/dl, 110-125 mg/dl, and 126 mg/dl or higher.
Blood glucose control strongly linked with number of natural teeth
The researchers then compared A1C and fasting glucose levels with the number of natural teeth participants had, also taking into account a number of factors including age and smoking status. They found that within each age group — participants in their 20s, 30s, 40s, 50s, or 60s — except for participants in their 20s, higher A1C was linked to a lower number of natural teeth. This relationship grew stronger as participants got older, with a sharper drop in the number of natural teeth linked to increasing A1C.
The researchers also found that fasting glucose levels corresponded to the number of natural teeth in the same age groups of 20s through 60s, when it came to having a level of 126 mg/dl or higher — a level that is often used to diagnose diabetes. But for participants in their 40s and 60s — and to weaker degree those in their 50s — there was also a link between elevated fasting glucose (110-125 mg/dl) and having fewer teeth. This result demonstrates that the risk to oral health may begin with any level of elevated blood glucose, even before reaching the diabetic range.
“Glycemic control is strongly associated with the number of natural teeth in the real-world setting,” the researchers concluded. “These data emphasize the importance of glycemic control and appropriate oral care for the protection against tooth loss.”