Diabetes: The Oral Health Link

Some of the most intriguing oral health research is attempting to connect the dots between diseases of the mouth and other illnesses. For example, a 2007 study published in the Journal of the National Cancer Institute reported that gum disease may increase the risk of developing pancreatic cancer. So far it’s unclear how periodontal disease might contribute to pancreatic cancer, and no definite cause-and-effect relationship has been proven, but the findings are intriguing and will no doubt spur further research.

Links between other health conditions and gum disease have been studied in greater depth. Under particular scrutiny is how periodontal disease may relate to diabetes, heart disease, and pregnancy complications.

What’s the Link?

For over a hundred years, doctors have noted the connection between diabetes and gum disease. Diabetes can cause circulatory damage that restricts blood flow to the gums. This can make the periodontal tissue and bone more susceptible to infection. In addition, high blood sugar translates into increased levels of sugar in oral fluids, which allows the bacteria responsible for periodontal disease to thrive.

Does It Work Both Ways?

Researchers are also probing the possibility that periodontal disease may be more than a complication of diabetes – it may actually be a factor contributing to the development of the condition. In an article published in a 2008 issue of Diabetes Care, researchers examined data from 9,296 adults who participated in the National Health and Nutrition Examination Survey (NHANES I) and its Epidemiologic Follow-up Study (NHEFS). None of the participants had been diagnosed with diabetes at the outset of the study. At the conclusion of the 20-year follow-up period, participants with moderate to severe periodontal disease had developed diabetes at twice the rate of individuals with no gum disease. People with advanced tooth loss had a 70 percent greater chance of getting diabetes. This correlation help up even after researchers controlled for other diabetes risk factors, such as smoking, diet, and obesity. Although there isn’t yet a firm conclusion as to why periodontal disease may increase diabetes risk, one theory is that the inflammation from oral infection increases the body’s resistance to insulin, which, in turn, makes it difficult to control blood sugar.

Several small studies suggest that periodontal therapy, such as deep cleaning, can improve blood sugar control. Researchers also are evaluating whether supplementing deep cleanings with oral antibiotics can help reduce blood sugar levels in diabetic patients.

Source: Dental Health for Adults: A Guide to Protecting Your Teeth and Gums. Copyright © by Harvard University. All rights reserved.