Does Diabetes Increase the Risk of Periodontitis?

Phillip Bonner, DDS

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The literature is conflicting on the association between diabetes and periodontitis. A systematic review published in Acta Diabetologica assessed whether poorly controlled diabetes was associated with periodontitis onset or progression.

Electronic searches were performed in PubMed, Scopus, and Embase databases. Hand search was carried out in the reference list of all articles included. Gray literature was investigated with a Google Scholar search.

Prospective longitudinal studies on the association between diabetes and periodontitis were considered for this review. Studies needed to have presented at least 2 measurements of periodontal conditions over time to be considered. Data on study design as well as crude and adjusted estimates were collected.

Meta-analysis was used to estimate the pooled effect of hyperglycemia in people with diabetes on periodontitis onset or progression. Meta-regression and subgroup analyses were employed to investigate potential sources of heterogeneity between studies. Thirteen studies matched the inclusion criteria, comprising 49,262 individuals, including 3,197 diagnosed with diabetes.

Meta-analyses of adjusted estimates showed that diabetes increased the risk of incidence or progression of periodontitis by 86% (RR 1.86 [95% CI 1.3–2.8]). However, there is scarce information on the association between diabetes and periodontal destruction.

The study provides evidence that diabetes is associated with increased risk of periodontitis onset and progression in adults. Upcoming prospective longitudinal studies should overcome methodological caveats identified in this review. (Source: Acta Diabetologica, March 3, 2018.)

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