Type 2 Diabetes and Periodontal Disease

Periodontitis may be an early sign of type 2 diabetes, according to new research published in the BMJ Open Diabetes Research and Care journal. The study was conducted by researchers at the University of Amsterdam and was made up of over 300 participants from the school’s dental clinic. Participants in the study either had no gum disease to moderate gum disease, and some had severe periodontitis.

Over 29 million Americans live with diabetes, according to the Centers for Disease Control. The CDC estimates that of this number, over 8 million Americans go undiagnosed. Type 2 diabetes is an adult onset of the autoimmune disease in which the body rejects insulin or does not make enough insulin.

Periodontitis is a severe form of gum disease that causes painful inflammation and infection of the gum tissue. The condition leads to tooth loss but has been found to have more serious health impacts like dementia, heart disease and rheumatoid arthritis.

Periodontitis begins as gingivitis, which is an irritation of the gum tissue that makes the gums swollen and red. Gingivitis is caused by the build up a dental plaque. Dental plaque is the soft, sticky film that forms over the teeth and gums. Plaque is home to many types of disease-causing bacteria. When plaque is not brushed away as part of a regular oral hygiene routine, bacteria take over, attacking and inflaming the gum tissue.

Study participants with severe periodontal disease had diabetes risk factors like being overweight, high blood pressure and high cholesterol. Researchers reviewed the blood sugar levels of participants and the rates of diabetes and prediabetes among the group.

The group with the highest blood sugar levels were found to be the group with the most cases of periodontitis. Of this group, 18 percent of participants had undiagnosed diabetes. The next largest group with high blood sugar levels, prediabetes or confirmed diabetes were the patients with mild to moderate gum disease. The group with no gum disease also had participants with diabetes that had not been diagnosed before the study.

Although a true link between diabetes and periodontitis was not confirmed as a result of the study, researchers on the project think many individuals would benefit from having their blood sugar checked at the dentist office during a checkup.

The Dutch study is not the only study to observe a connection between the conditions. The American Academy of Periodontology states that people with diabetes have a higher risk of developing periodontitis and other gum infections because diabetes lowers the immune system's ability to fight off infection. The AAP also cautions that patients who do not control their diabetes and those who are unaware of their condition have an even higher risk of developing periodontal and other oral health complications.

The AAP also suggests that a patient’s ability to control diabetes is impacted by their gum condition. Periodontal disease increases blood sugar in many individuals, putting a strain on the body and leaving the patient at risk for further health complications.

"Dentists are often the first to notice serious health symptoms that may indicate illness or disease," said Dr. Amy Norman, D.D.S, P.S, an Everett, Washington, dentist who asks her patients to provide a health history as part of their exam paperwork.

"We ask for a complete health history so we can be aware of potential health conditions that present themselves in the mouth," Norman said.

Aside from diabetes, other conditions the show up as symptoms in the mouth. These conditions include gastroesophageal reflux disease, stomach cancer, heart problems, brain tumors and even pregnancy.

Not only do dental checkups reveal potentially dangerous health conditions, they also lead to prevention in other cases.

"If a patient comes in for a dental check-up with periodontitis and other health symptoms that add up to a particular diagnosis, I would recommend that they see a specialist for a further look," Norman said.


Medical News Today. "Periodontitis may be an early sign of Type 2 diabetes." 23 February 2017

American Academy of Periodontology. "Diabetes and Periodontal Disease." 2017

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