New research from the City of Hope National Medical Center in Duarte, Calif, adds to the growing evidence of a link between poor oral health and an increased risk of diabetes. Plus, the researchers note, dental professionals can play a greater role in identifying those at risk and steering them toward preventive treatment.
“We found a progressive positive relationship between worsening glucose tolerance and the number of missing teeth,” said Raynald Samoa, MD, lead author of the study. “Although a causal relationship cannot be inferred from this cross-sectional study, it demonstrates that poor dental outcome can be observed before the onset of overt diabetes.”
The researchers reviewed the records of 9,670 adults 20 years of age and older examined by dentists during the 2009-2014 National Health and Nutrition Examination Survey. They looked at reported body mass index and glucose tolerance states by fasting plasma glucose, two-hour post-challenge plasma glucose, hemoglobin A1c, established diabetes, and whether the condition was treated with oral agents or insulin.
Also, they recorded the numbers of missing teeth due to caries and periodontal disease for individual patients. They further determined the relationship between glucose tolerance and dental condition by considering age, gender, racial and ethnic group, family history of diabetes, smoking status, alcohol consumption, education, and poverty index.
The authors found a progressive increase in the number of patients with missing teeth as glucose tolerance declined, from 45.57% in the group with normal glucose tolerance (NGT) to 67.61% in the group with abnormal glucose tolerance (AGT) to 82.87% in the group with diabetes mellitus (DM).
Except for gender, all other covariates had a significant impact on the number of missing teeth. The differences in the average number of missing teeth among the groups also were significant: 2.26 in the NGT group, 4.41 in the AGT group, and 6.80 in those with DM.