Impact of periodontal treatment on incipient diabetes

Background + Aims

• Periodontitis (gum disease) is a chronic inflammatory condition affecting the tissues that support teeth. It has been associated with systemic conditions like cardiovascular disease and diabetes.
• Poor oral health could contribute to inflammation that worsens insulin resistance, potentially increasing the risk of developing type 2 diabetes.
• This study aimed to investigate whether the severity of periodontitis or poor treatment outcomes influences the risk of developing diabetes in the future.

Materials + Methods

• 8,983 individuals in Sweden referred for periodontal treatment between 1980 and 2015. None had diabetes at baseline
• Periodontal health was evaluated by the number of teeth, probing pocket depth (PPD) ≥5 mm, and bleeding on probing (BOP).
• Participants were monitored for 21.3 years (median follow-up) to track new cases of diabetes using national health records.
• A subgroup of 5,258 participants were followed up 1 year after periodontal treatment.
  • Those with >10% PPD ≥5 mm and BOP at ≥20% of sites were classified as poor responders to treatment.
• Statistical models adjusted for age, sex, smoking, education level, and marital status.

Results

• Greater tooth loss and higher levels of BOP were associated with a higher risk of developing diabetes.
  • Individuals with more teeth had a 12% lower risk of diabetes for every quintile increase.
• Poor responders to periodontal treatment had a 37% higher risk of developing diabetes compared to good responders. This risk was particularly pronounced in smokers.
• Over the study period, 12.4% of participants developed diabetes, with higher incidence rates in those with severe periodontitis and poor treatment outcomes.

Limitations