Impact of periodontal treatment on incipient diabetes

Background + Aims

• Chronic periodontitis is a prevalent inflammatory condition affecting the supporting structures of teeth, which can lead to tooth loss and has been associated with various systemic diseases, including diabetes. The relationship between oral health and systemic conditions has garnered increasing attention, particularly as periodontal disease may influence metabolic processes. Previous studies have suggested that individuals with periodontal disease may have a higher risk of developing diabetes due to shared risk factors such as inflammation and insulin resistance.
• Understanding the dynamics of this relationship is crucial for developing preventive strategies.
• The study aims to assess the association between changes in periodontal disease status and the risk of developing diabetes, particularly focusing on individuals who recovered from the chronic periodontal disease compared to those who remained periodontally healthy or developed periodontitis.

Materials + Methods

• A longitudinal cohort study involving health screenings over multiple years. Individuals with less than two health screenings or a history of diabetes before the second screening were excluded.
• Baseline characteristics such as age, sex, BMI, cholesterol levels, and lifestyle factors (smoking, alcohol consumption, physical activity) were collected.
• Professional dentists assessed periodontitis through oral examinations, measuring gingival inflammation and periodontal pocket depth (PPD).
• Participants were categorised into four groups based on periodontal status: PD-free, PD-recovered, PD-developed, and PD-chronic.
• Cox proportional hazard regression was used to determine the hazard ratios for diabetes, adjusting for confounding variables.

Results

• 111,611 subjects with identifiable periodontal status at two or more health screenings were included. Among the 111,611 subjects, 29.83% were PD-free, 20.06% were PD-recovered, 18.28% developed PD, and 31.83% had chronic PD.
• The study found that individuals who recovered from PD had a significantly lower risk of developing diabetes compared to those with chronic PD. The results were statistically significant, with p-values < 0.05 indicating robust findings.
• Additional analyses confirmed that the relationship between PD recovery and reduced diabetes risk remained consistent across different definitions of PD.
• The study highlighted variations in diabetes risk based on age, sex, and economic status, emphasising the need for tailored health interventions.

Limitations