Tooth loss may signify T2D risk
Tooth loss or missing teeth due to decay or periodontal disease may suggest an increased risk of type 2 diabetes (T2D), according to a study presented at ENDO 2018 held in Chicago, Illinois, US.
Dental caries and periodontal disease are hallmarks of poor dental health which, if left untreated, may lead to tooth loss, said lead author Dr Raynald Samoa from the Department of Diabetes, Endocrinology & Metabolism at the City of Hope National Medical Center in Duarte, California, US. “Our results showed a progressive positive relationship between worsening glucose tolerance and number of missing teeth.”
Samoa and colleagues established the link between dental health and glucose tolerance by reviewing records of 9,670 adults (>20 years) and evaluating the following parameters: body mass index (BMI) and glucose tolerance states by fasting plasma glucose, 2-hour post-challenge plasma glucose, HbA1c, established T2D, and treatment with oral agents or insulin. Participants were divided into three groups according to glucose tolerance (GT): normal (NGT), abnormal (AGT), or T2D. Dental records were documented to determine the number of decayed or missing teeth caused by caries or periodontal disease and periodontal status. [ENDO 2018, abstract MON-118]
The incidence of missing teeth was highest among those with reduced glucose tolerance (45.57 percent, 67.61 percent, and 82.87 percent in the NGT, AGT, and T2D groups, respectively; p<0.000001), which remained significant even after adjusting for covariates* (p=0.000019).
There was also a significant difference in the average number of missing teeth among the three groups (2.26, 4.41, and 6.80 in the NGT, AGT, and T2D groups, respectively; p<0.000001).
Excluding gender, all other covariates had a significant impact on the number of missing teeth (p=0.000002 for BMI, p<0.000001 for other covariates).
“[Our findings suggest that] the health of your teeth may be a sign of your risk for [T2D, which] is estimated to increase the risk of periodontitis by two- to threefold,” said Samoa. “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,” he added.
These results support evidence linking severe periodontitis to a higher risk of poor glycaemic control, said Samoa. Given the growing incidence of T2D, a dental examination could be an essential tool that could help identify patients at risk for developing T2D, he added.