Association between periodontitis and diabetes

Background + Aims

• Diabetes mellitus (DM) is associated with severe systemic and oral health complications, including periodontitis, which is characterised by gum inflammation, periodontal tissue damage, and tooth loss.
• Pre-diabetes, a metabolic condition with elevated blood glucose levels below the diabetic threshold, is also linked to complications like nephropathy and neuropathy.
• This study explored the prevalence and severity of periodontitis and tooth loss in individuals with previously undiagnosed pre-diabetes or diabetes, compared to normoglycaemic individuals.
• It aimed to investigate whether periodontal disease can serve as an early clinical indicator of metabolic dysregulation in individuals with dysglycaemia, emphasising the role of dentists in early diagnosis and referral for diabetes management.

Materials + Methods

• This cross-sectional study included 1,097 participants (aged ≥30 for non-White/Hispanic and ≥40 for White, non-Hispanic individuals) who met the criteria for diabetes risk. None had prior diagnoses of diabetes or pre-diabetes.
• Participants underwent full-mouth periodontal examinations, including bleeding on probing (BOP), probing depth (PD), and tooth loss.
• Participants had point-of-care (POC) HbA1c testing to determine glycaemic status (normoglycaemic, pre-diabetic, diabetic).
• Statistical analysis adjusted for confounders (e.g., age, sex, ethnicity, smoking, BMI, and cholesterol) to assess relationships between glycaemic categories and periodontal measures.

Results

• Prevalence:
  • 55% of participants were normoglycaemic
  • 37.3% pre-diabetic
  • 7.7% diabetic
• Periodontal Health:
  • BOP and PD ≥5 mm were significantly higher in diabetic patients compared to pre-diabetics and normoglycaemic individuals.
  • Pre-diabetics exhibited intermediate periodontal disease levels, suggesting a progression from normoglycaemia to diabetes.
• Tooth Loss:
  • Tooth loss increased significantly across groups (normoglycaemic < pre-diabetic < diabetic).
  • Statistical models confirmed significant differences in periodontal disease and tooth loss between glycaemic groups after adjustments.

Limitations