Gum Disease & Diabetes: “A Two-Way Relationship”

gum diseaseWe’ve known for a long time that diabetes and gum disease often occur together. Now new research continues to show just how strong that association is.

For instance, one recent study of more than 300 dental patients found that those with gum disease were more likely to have type 2 diabetes than those who had healthy mouths. The more advanced the disease, the greater the likelihood.

In addition, according to the American Diabetes Association (ADA) guidelines for diagnosis, there was a significant over-representation of subjects with suspected diabetes (23% and 14%) and pre-diabetes (47% and 46%) in the severe periodontitis group and mild/moderate periodontitis groups, respectively, compared with the control group…. Notably, 18.1% of patients with suspected new diabetes were found among subjects with severe periodontitis compared with 9.9% and 8.5% among subjects with mild/moderate periodontitis and controls, respectively.

Because of this, the authors suggest that the dental office is “a suitable location for screening for (pre)diabetes.”

Why should these two conditions happen so often together?

The mechanisms that underpin the links between these two conditions are not completely understood, but involve aspects of immune functioning, neutrophil activity, and cytokine biology. There is emerging evidence to support the existence of a two-way relationship between diabetes and periodontitis, with diabetes increasing the risk for periodontitis, and periodontal inflammation negatively affecting glycaemic control.

Recent research in Cell Host & Microbe suggests that one factor may be changes in the composition of bacteria that live in the mouth. Those changes that the research team observed made the oral microbiome more apt to cause disease. The result was more inflammation and more bone loss.

These findings, notes a news release, “’demonstrate unequivocally’ that diabetes-induced changes in the oral microbiome drive inflammatory changes that enhance bone loss in periodontitis, the authors wrote.”

“Diabetes is one of the systemic disease that is most closely linked to periodontal disease, but the risk is substantially ameliorated by good glycemic control,” [senior study author Dana Graves] said. “And good oral hygiene can take the risk even further down.”

Indeed, earlier research has shown that treating gum disease is associated with a lowering of HbA1c levels, which is why regular dental care is increasingly considered an important part of diabetes management.

That care involves more than just things like periodontal surgery, regular cleanings, and practicing good home hygiene. It also means making the healthy lifestyle choices that support good oral and systemic health alike. That starts with the food we eat, a point we hit on in our earlier post “Reversing Diabetes Might Be Simpler than You Think”

Image by Parveen Chopra

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