Welcome to the Research Hub – your go-to source for concise, digestible summaries of the latest research on the connection between periodontitis and diabetes. Explore key findings on topics such as how periodontal inflammation affects glycaemic control and the benefits of periodontal treatment.
Our summaries provide quick insights, but they are not exhaustive. For a complete understanding of each study’s methodology, results, and implications, we encourage you to review the original research articles. Please note that the Periodontitis-Diabetes hub is not responsible for inaccuracies or misinterpretations of condensed content.
For more guidance on understanding research, including how to interpret studies and evaluate their findings, visit the ‘Colgate Professional Website’ and search for ‘Understanding Research in Dentistry.’
Dive into the science and uncover the powerful link between oral and systemic health!
In a mouse model of type 2 diabetes, experimentally induced gum disease worsened diabetic nephropathy (DN — kidney damage caused by diabetes) by activating an enzyme–hormone pathway (HPGDS–PGD2) inside the kidney’s filtering units (glomeruli). Blocking this pathway with a drug protected the kidneys. A small clinical study in patients suggested a possible link between urinary HPGDS, kidney function and gum disease.
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This study in mice found that diabetes-related changes in gut bacteria weakened the gut’s protective lining and increased oxidative stress, worsening gum inflammation and bone loss. Restoring healthier gut bacteria, protecting the gut lining or giving oleic acid reduced this damage, but studies in people are needed to confirm these benefits.
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Periodontitis is associated with systemic inflammation and has been linked to chronic kidney disease and diabetes. This randomised trial examined whether non-surgical periodontal treatment improves kidney function, systemic inflammation and blood glucose control in patients with chronic kidney disease.
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A combination of bacteria and inflammatory markers in saliva distinguished participants with type 2 diabetes and periodontitis from systemically healthy participants without periodontitis, with reported accuracy of 95%. Further testing is needed to establish whether it can reliably identify gum disease within the diabetic population.
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In mice, butyrate (a substance produced by gut bacteria) reduced diabetes-associated periodontal damage and restored the balance between two types of immune cells. Whether this approach benefits people remains unproven.
Read more
Adding Limosilactobacillus reuteri probiotics to periodontal treatment did not provide additional improvements in gum health or overall bacterial outcomes in patients with diabetes. A possible improvement in blood glucose control was observed, but it was not statistically significant in a separate analysis excluding participants with protocol deviations.
Read more
In a large Swedish register-based study of nearly 19,000 people with dental implants, both type 1 diabetes (T1DM) and type 2 diabetes (T2DM) were associated with a higher risk of peri-implantitis (inflammation and progressive bone loss around a dental implant). The link was clearest for T1DM, particularly when blood-sugar control was poor.
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In diabetic mice, oxidative stress (an imbalance between damaging free radicals and the body’s antioxidant defences) and gut dysbiosis (an unhealthy shift in gut bacteria) appear to fuel each other, worsening periodontitis (inflammatory destruction of the tissues supporting the teeth). Both an antioxidant (curcumin) and faecal microbiota transplantation (FMT — transfer of stool bacteria from a healthy donor) reduced this damage.
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In a mouse model of type 2 diabetes, experimentally induced gum disease worsened diabetic nephropathy (DN — kidney damage caused by diabetes) by activating an enzyme–hormone pathway (HPGDS–PGD2) inside the kidney’s filtering units (glomeruli). Blocking this pathway with a drug protected the kidneys. A small clinical study in patients suggested a possible link between urinary HPGDS, kidney function and gum disease.
Read more
In 43 patients with metabolic syndrome, a 5–10-day medically supervised prolonged fast was associated with lower gum inflammation, less plaque and small, selective shifts in oral bacteria. The overall oral microbiome remained largely stable.
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In a nationwide Japanese cohort of 99,273 middle-aged adults with type 2 diabetes mellitus (T2DM), those who attended a dentist for periodontal care had a 32%–47% lower risk of starting dialysis (a treatment that filters the blood when the kidneys fail) than those with no dental attendance. More frequent visits were linked to greater risk reduction, suggesting that routine gum care may help protect kidney function in diabetes, although the study is observational and cannot prove cause.
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Type 2 diabetes mellitus (T2DM) is a growing global health issue, with millions remaining undiagnosed.In Singapore, diabetes prevalence is among the highest in Southeast Asia, with half of those affected unaware of their condition at diagnosis.
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In 104 pregnant women, extracellular vesicles (EVs — tiny membrane-wrapped particles released by cells and bacteria that carry proteins and other molecules) collected from the gum crevice were more abundant, and had a distinctive surface-marker profile, in women with both periodontitis and gestational diabetes mellitus (GDM). Their protein cargo pointed to roles in immune inflammation, glucose metabolism and insulin response, and included virulence factors from periodontal bacteria – supporting the idea that gum-derived EVs may biologically link periodontitis and GDM.
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Higher dietary quality was associated with differences in subgingival bacterial diversity and a more favourable balance of disease-associated to health-associated bacteria. These observational findings suggest a possible link between diet and the periodontal microbiome, rather than demonstrating a treatment effect.
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Periodontitis was associated with a higher incidence of cardiovascular events or death over approximately 10 years, after adjustment for age, smoking and diabetes.
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Higher oral microbiome diversity was associated with lower all-cause mortality over approximately 9-years. Associations were also observed in participants with diabetes and hypertension, although these findings do not establish causality.
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Experimentally induced diabetes increased peri-implant bone loss, inflammation and connective-tissue disruption in mice. The findings provide biological evidence of diabetes-related susceptibility, but do not establish the magnitude of risk in humans.
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Higher cardiovascular health scores were associated with lower odds of periodontitis in US adults. The association was more pronounced for health behaviours, particularly nicotine exposure, than for physiological health factors.
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Periodontitis affects up to 45% of adults in the United States (US) and has been significantly associated with various systemic health conditions such as diabetes and cardiovascular disease. Current research suggests that periodontal disease may not only impact oral health but also influence overall mortality.
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Periodontitis is a chronic inflammatory disease affecting the supporting structures of the teeth, leading to progressive periodontal tissue destruction and eventual tooth loss if untreated. The main aetiological factor for periodontitis is plaque. However, the two main risk factors for progression of the disease have been identified as smoking and diabetes.
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Periodontal disease is commonly seen in individuals with diabetes, particularly with Type 2 diabetes mellitus (T2DM). The chronic inflammation associated with periodontal disease can exacerbate glycaemic control issues and contribute to the progression of diabetes. There is increased evidence regarding the bidirectional relationship between periodontitis and diabetes. Poor glycaemic control can worsen periodontal health, while periodontitis can further impair glycaemic control, creating a vicious cycle.
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Type 2 diabetes mellitus (T2DM) is a metabolic condition characterised by elevated blood sugar levels due to insufficient insulin function. Effective glycaemic control is crucial for minimising the risk of both microvascular and macrovascular complications. Research indicates that even a 1% reduction in HbA1c levels can significantly lower the incidence of related health issues.
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Prediabetes is increasingly recognised as a major public health issue, affecting about 35% of adults in the United States (US), or roughly 88 million people. While it serves as a significant indicator for developing diabetes, prediabetes is reversible, with around 13% of individuals returning to normal glucose levels. Managing risk factors during the prediabetic phase could alleviate the diabetes burden, a leading cause of morbidity and mortality.
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Periodontal breakdown can lead to further damage in nearby tissues if not treated adequately. Extracting a hopeless or non-essential adjacent tooth can enhance the survival of molars that have undergone periodontal treatment.
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Diabetes mellitus (DM) has associated complications, ranging from cardiovascular issues to kidney diseases, which impose a considerable burden on both those living with diabetes and the healthcare system at large. Effective management of blood sugar levels is pivotal in averting these complications and enhancing the overall outlook for individuals with diabetes.
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Diabetes mellitus (DM) is a global health concern, affecting 537 million people worldwide and accounting for 10% of healthcare expenditure in developed countries.
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Supportive periodontal care (SPC) is critical for maintaining periodontal stability and preventing recurrence of periodontitis. Personalising treatment plans is increasingly essential due to varying chronic illnesses and patient capacities. Periodontal breakdown during SPC often necessitates additional active therapy, highlighting the need for robust risk assessment tools.
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Periodontitis, a chronic inflammatory disease affecting the supporting structures of the teeth, has been linked to various systemic health issues, including cardiovascular disease and diabetes. Given the increasing prevalence of both diabetes and periodontal disease, understanding their interplay is crucial for public health.
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The study investigates the association between periodontal diseases and chronic obstructive pulmonary disease (COPD), motivated by emerging evidence suggesting a potential link between oral health and respiratory conditions.
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The study represents a significant contribution to the understanding of long-term outcomes in periodontal treatment, specifically for patients diagnosed with stages III and IV periodontitis. With the ultimate goal of preserving natural teeth for life, the research addresses the critical need for comprehensive data on tooth loss and treatment efficacy over extended periods.
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Diabetes mellitus (DM) is a significant risk factor for periodontal disease, characterised by hyperglycaemia, chronic inflammation, and compromised immune defence. Poorly controlled blood glucose levels increase the prevalence and severity of periodontal disease, impacting the quality of life for affected individuals. Recent research has introduced the concept of ‘inflamm-ageing’- a pro-inflammatory state linked to diabetes that exacerbates tissue damage through macrophage activation.
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There is a well-established bidirectional relationship between periodontitis and diabetes. Individuals with poorly controlled diabetes are at a higher risk of developing periodontal disease due to the effects of hyperglycaemia on immune function and tissue healing. On the other hand, periodontal disease can exacerbate glycaemic control, leading to increased insulin resistance and worsening metabolic outcomes. The systemic inflammation associated with periodontal disease is believed to contribute to the pathophysiology of diabetes, as inflammatory mediators can interfere with insulin signalling pathways.<
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Periodontal disease, a chronic inflammatory condition affecting the supporting structures of teeth, is prevalent among individuals with diabetes, who are often at a heightened risk due to compromised immune responses and metabolic dysregulation. Conversely, poor glycaemic control has been implicated in the progression of periodontal disease, suggesting a bidirectional relationship that warrants further investigation.
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Peri-implant diseases (PIDs), including peri-implant mucositis and peri-implantitis, are significant complications that can arise following dental implant placement. These conditions are characterised by inflammation of the peri-implant tissues, which can lead to implant failure if not managed effectively.
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Periodontal treatment involves a stepwise framework, including non-surgical sub-gingival instrumentation as the cornerstone for managing periodontitis. This reduces gingival inflammation, probing pocket depth (PPD), and clinical attachment loss (CAL) while improving overall health and quality of life. However, non-surgical treatment can induce an acute-phase systemic inflammatory reaction post-operatively, including increased acute-phase proteins, endothelial dysfunction, elevated body temperature, clotting tendencies, and renal function reduction.
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Metabolic syndrome (MetS) is a cluster of conditions—obesity, dyslipidemia, hypertension, and insulin resistance—that significantly increase the risk of diabetes and cardiovascular disease.Periodontitis, a chronic inflammatory disease of the gums, has been linked to systemic inflammation, insulin resistance, and worsening glycaemic control.
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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.
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Periodontitis, a chronic inflammatory condition, is a leading cause of tooth loss in adults and is exacerbated by diabetes-related hyperglycemia.Diabetes promotes periodontal inflammation and disrupts alveolar bone homeostasis, contributing to tissue damage. Alveolar bone homeostasis involves the endocrine system, signaling interactions between bone and immune cells, and mechanically loaded forces. It relies on bone-resorbing osteoclasts, bone-producing osteoblasts, their precursors and immunoregulatory mediators.
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Diabetes mellitus (DM) is a chronic condition where the body fails to produce or effectively use insulin, resulting in elevated blood glucose. Poor glycaemic control in DM patients can lead to severe complications like cardiovascular disease and kidney failure. The glycosylated haemoglobin assay (HbA1c) is a reliable measure of long-term blood sugar control and is linked to the risk of diabetic complications.
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Diabetes mellitus (DM) is a significant global health issue, often remaining undiagnosed during its asymptomatic phase. Timely detection can prevent complications. Given the bidirectional link between diabetes and periodontitis, dental professionals are uniquely positioned to identify undiagnosed hyperglycaemia using periodontal measures.
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Periodontitis is a chronic inflammatory disease leading to the destruction of tooth-supporting tissues and eventual tooth loss if untreated. It is highly prevalent worldwide, affecting 10–60% of populations. Beyond oral health, periodontitis contributes to systemic diseases by allowing pathogens (bacteria) and inflammatory mediators to enter the circulatory system, increasing risks for conditions like diabetes mellitus (DM), cardiovascular diseases, and adverse pregnancy outcomes.
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Tooth loss (TL), a significant outcome of periodontitis, affects patients physiologically and psychologically. Periodontal therapy and patient compliance during supportive periodontal care (SPC) are crucial in reducing TL risk.Studies highlight patient- and tooth-related factors influencing TL, including periodontal bone loss, tooth mobility, furcation involvement (FI), tooth type, and vitality, with FI identified as a major predictor of molar survival.
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Periodontitis (gum disease) is a chronic inflammatory condition affecting the tissues that support teeth. It has been associated with systemic conditions like cardiovascular disease and diabetes.
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Periodontitis is a chronic inflammatory condition that causes gum and bone damage. It is often linked with systemic inflammation and conditions like metabolic syndrome (MetS).
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Diabetes mellitus (DM) accelerates periodontal disease through hyperglycaemia-induced inflamm-ageing, a chronic, low-grade inflammatory state driven by cellular senescence and the senescence-associated secretory phenotype (SASP). Inflamm-aging disrupts gingival defence mechanisms, including epithelial and fibroblast resistance and immune responses to infection.
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Periodontal maintenance (PM) is crucial for preventing the progression of periodontitis and minimising tooth loss after active periodontal treatment (APT). It includes tailored care such as oral hygiene education, scaling, root planing, and tooth polishing. Despite advances in periodontal therapy, factors like age, smoking, diabetes, and compliance with PM visits impact treatment outcomes.
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Periodontitis is a chronic inflammatory disease causing tissue destruction and tooth loss, often requiring lifelong management. Regular maintenance, termed supportive periodontal therapy (SPT), plays a crucial role in preventing disease progression. The World Workshop (2017) introduced a multidimensional classification for periodontitis, categorising cases into stages (severity) and grades (rate of progression). This study aims to evaluate how the regularity of maintenance visits impacts tooth loss related to periodontitis (TLP) based on staging and grading. It hypothesises that higher disease severity (stages III/IV) and rapid progression (grade C) increase susceptibility to tooth loss, especially with inconsistent maintenance.
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Periodontitis and type 2 diabetes are linked through a bidirectional relationship: diabetes increases the risk and severity of periodontitis, while periodontal inflammation worsens glycaemic control.
Systemic inflammation, driven by cytokines, contributes to complications such as cardiovascular disease and stroke. Associations between severe periodontitis and cardiovascular diseases have also been well-established.
Diabetes mellitus (DM) is a prevalent chronic condition, often undiagnosed, and associated with significant morbidity. Periodontitis is a chronic gum disease linked to systemic inflammation, and dental settings have been proposed as a location for screening undiagnosed DM and prediabetes.
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Periodontitis, a chronic gum disease, involves inflammation and tissue destruction. It is especially common in people living with diabetes, making diagnosis and monitoring crucial.
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Periodontitis has been linked to various systemic diseases, including diabetes, cardiovascular disease, and rheumatoid arthriti
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Partial-mouth protocols (PMPs) are commonly used in population health studies to estimate periodontal disease prevalence, offering a cost-effective and time-efficient alternative to full-mouth protocols (FMPs). However, PMPs are known to underestimate periodontal disease prevalence, which may lead to biases in studies examining associations between periodontitis and systemic conditions like diabetes and cardiovascular disease (CVD).
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Periodontitis, a chronic inflammatory disease caused by bacterial plaque, is associated with systemic conditions such as cardiovascular diseases, diabetes, and adverse pregnancy outcomes. It has also been linked to increased mortality risks
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Periodontal disease, affecting hundreds of millions adults globally, is a leading cause of tooth loss and negatively impacts oral health-related quality of life.
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Inflammation plays a pivotal role in cardiovascular disease (CVD) progression, particularly in patients with diabetes mellitus (DM) and periodontitis, which share risk factors and systemic inflammatory pathways.
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Periodontitis, affecting 11.2% globally, causes tissue destruction, tooth loss, and reduced quality of life. Its bidirectional link with type 2 diabetes mellitus (T2DM) is well-established, with diabetes increasing periodontitis risk and periodontitis worsening glycemic control.
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Periodontitis progression is influenced by common risk factors, including poor oral hygiene, smoking, and lifestyle habits. Interventions targeting these factors can improve treatment outcomes and periodontal health.
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This 12-year study investigated whether periodontitis was associated with changes in blood glucose from early adulthood to age 38. The authors concluded that there was no clear overall association, although 1 analysis identified a small increase in HbA1c in participants with the highest blood glucose trajectory.
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Chronic kidney disease (CKD) involves impaired kidney function, increasing the risk of cardiovascular disease, infection, and mortality. Despite medical advances, CKD prevalence is rising globally.
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A model combining age, gender, ethnicity, smoking and HbA1c identified moderate-to-severe periodontitis with reasonable screening performance. It could help medical professionals identify patients needing periodontal assessment, but requires external validation before wider clinical use.
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Periodontitis and diabetes mellitus (DM) are closely linked, with DM being a significant risk factor for severe periodontitis. Conversely, periodontitis may exacerbate glycaemic management in people living wiith diabetes.
Non-surgical periodontal therapy is an effective treatment to reduce inflammation and improve periodontal health. However, there is uncertainty regarding how diabetes impacts the clinical response to periodontal treatment.
The global rise in type 2 diabetes is a significant contributor to disability and early mortality, often due to vascular and renal complications. Chronic inflammation affects glycaemic control in diabetes, linking it with cardiovascular and kidney diseases. Periodontitis, a prevalent inflammatory condition often co-existing with diabetes, involves an imbalance in oral bacteria and elicits a systemic inflammatory response, raising risks for severe conditions like cardiovascular disease and renal failure. Periodontal therapy aims to manage inflammation through dental cleaning, oral hygiene advice, and possible surgical intervention.
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Most patients retained the majority of their teeth over 20 years after periodontal treatment, with regular maintenance associated with less tooth loss and smoking with greater loss. Diabetes was also associated with tooth loss, but inconsistencies in the reporting prevent a clear interpretation of its effect.
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Diabetes mellitus (DM) is closely associated with periodontitis, with evidence suggesting a bidirectional relationship. While periodontitis may exacerbate systemic inflammation and insulin resistance, periodontal therapy is hypothesised to improve glycaemic management and reduce inflammation in people living with diabetes.
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Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterised by insulin resistance and elevated blood glucose levels, influenced by factors like obesity and inflammation.
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Patients with type 2 diabetes mellitus (T2DM) exhibit higher prevalence and severity of chronic periodontitis compared to individuals without diabetes.
Non-surgical periodontal therapy (NSPT), including scaling and root planing (SRP), has been suggested to improve glycaemic control in T2DM patients.
This study investigated whether 2 microRNAs in gingival crevicular fluid could help identify periodontitis in people with and without type 2 diabetes. Both markers were elevated in periodontitis and decreased after non-surgical treatment, suggesting potential roles in disease assessment and monitoring treatment response.
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The human microbiome plays a vital role in health, with links between gut microbiota and metabolic disorders like type 2 diabetes mellitus (T2DM).The oral microbiota, particularly the subgingival microbiome, is thought to be influenced by diabetes.
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This animal study investigated whether green tea could protect periodontal tissues during prolonged hyperglycaemia in rats with type 1 diabetes. Green tea consumption preserved measures of the small blood vessel network and reduced periodontal destruction, although it did not completely prevent disease.
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Gestational diabetes mellitus (GDM) is a carbohydrate intolerance which begins during pregnancy, with Indian women at significantly higher risk (approximately 11-fold) compared to Caucasians.
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Chronic periodontitis is a common inflammatory disease that causes progressive bone loss and, if untreated, can lead to tooth loss.
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This experimental study investigated how osteocytes (cells embedded within bone) contribute to periodontal bone loss in mice with and without diabetes. Deleting their production of RANKL (a signal that promotes bone breakdown) prevented significant infection-induced bone loss in both groups.
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This human study investigated whether diabetes and smoking were associated with increased levels of proteins that inhibit bone formation in people with periodontitis. Both risk factors were linked to changes in sclerostin and DKK1, suggesting a possible mechanism through which periodontal bone maintenance and repair may be impaired.
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This systematic review examined whether periodontitis was associated with poorer blood glucose control, development of type 2 diabetes and diabetes-related complications. The evidence generally supported these associations, although differences in study quality and methods limited the strength of the conclusions.
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Periodontitis is a widespread condition affecting over half of the global adult population, with prevalence increasing with age.Severe periodontitis is one of the most common human diseases, contributing significantly to tooth loss.
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This preliminary randomised trial investigated whether periodontal treatment changed inflammatory gene expression in blood-derived cells involved in vascular repair in people with type 2 diabetes. Treatment improved periodontal health and reduced IL-6 and IL-8 gene expression, but did not demonstrate corresponding improvements in HbA1c, systemic inflammation or secretion of these proteins.
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This animal study investigated whether activation of the enzyme PARP contributes to the greater periodontal destruction associated with diabetes. Blocking PARP reduced gingival inflammation, nitrosative stress and bone loss in diabetic rats, without significantly changing blood glucose or HbA1c.
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Diabetes mellitus (DM), particularly type 2 (T2DM), is prevalent in the elderly and associated with complications like neuropathy, retinopathy, and cardiovascular issues. Poor glycaemic management exacerbates these complications, significantly affecting quality of life. Periodontitis, a chronic inflammatory disease of the gums, is common in individuals with T2DM. Research indicates a two-way relationship: Periodontitis worsens gum health, while DM elevates systemic inflammation, impairing blood glucose control. In Japan, over half the population aged 40+ years experiences periodontitis. Addressing periodontitis could potentially improve glycaemic management in people with T2DM. This study aimed to assess whether dental visits for periodontal treatment correlate with improved diabetes outcomes in an elderly Japanese cohort.
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There is increasing evidence linking periodontal inflammation to elevated glycated haemoglobin (HbA1c) levels in patients with type 2 diabetes mellitus (T2DM). Periodontal disease is more prevalent in those with T2DM and contributes to chronic inflammation, potentially raising HbA1c levels. Persistently high HbA1c can lead to severe complications such as cardiovascular disease, blindness, amputations, renal failure, and premature death.
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This animal study investigated whether damage to mitochondria (the energy-producing structures within cells) could help explain why diabetes worsens periodontitis. Rats with both conditions showed greater periodontal destruction, increased mitochondrial oxidative stress and reduced cellular energy availability compared with rats with periodontitis alone.
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This Canadian population study examined whether previously unrecognised blood glucose abnormalities and other cardiometabolic risk factors were associated with periodontitis. Elevated fasting glucose was associated with higher odds of periodontitis, but this association was no longer statistically significant after accounting for household income and education.
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Pre-diabetes was associated with greater gum bleeding and severe periodontitis in adults without diabetes. Insulin resistance was associated with bleeding, but its association with severe periodontitis did not reach statistical significance.
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Diabetes risk and insulin resistance are associated with chronic systemic inflammation, often exacerbated by microbial factors. Inflammation interferes with insulin signalling, increasing diabetes susceptibility. Periodontitis, a chronic infection of the tooth-supporting structures, is linked to systemic inflammation and glucose intolerance. Emerging research suggests that early microbial changes in the subgingival environment may play a pivotal role in insulin resistance. The study aimed to investigate the relationship between subgingival bacterial composition, systemic inflammation, and insulin resistance in individuals living without diabetes. The hypothesis posited that dysbiosis (bacterial imbalances) in the subgingival microbiome would correlate with elevated inflammation and insulin resistance markers and that systemic inflammation would mediate this relationship. By identifying specific microbial signatures linked to inflammation and glucose regulation, the study hoped to improve early detection of diabetes risks and inform future intervention strategies.
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Repeated antimicrobial photodynamic therapy and oral doxycycline, each combined with periodontal cleaning, improved periodontal measures and HbA1c over 3-months. Photodynamic therapy showed advantages for certain moderate-depth pockets, but neither treatment produced a significantly greater improvement in glycaemic control.
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Chronic kidney disease (CKD) affects 8–13% of the global population and is linked to higher mortality, primarily from cardiovascular disease (CVD).Systemic inflammation is a key non-traditional risk factor in CKD.
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This animal study investigated whether blocking the inflammatory protein TNF-α could improve periodontal and metabolic outcomes in obese diabetic rats. Etanercept reduced markers of insulin resistance and appeared to lessen diabetes-associated periodontal destruction, while periodontitis itself did not significantly worsen the measured metabolic or kidney outcomes.
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This study examined whether periodontitis and its treatment were associated with changes in parathyroid hormone and active vitamin D. In patients with type 1 diabetes, parathyroid hormone increased after periodontal treatment, particularly in those with more severe disease, but its changes did not consistently track changes in active vitamin D.
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Gestational diabetes mellitus (GDM) and periodontal inflammation are independently associated with adverse pregnancy outcomes, including preterm birth, preeclampsia, and low birth weight.
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Severe periodontitis was associated with wider retinal venules (the small vessels carrying blood away from the retina). The association was significant in participants with diabetes, but not in those without diabetes.
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This study examined the relationship between periodontal bone loss, nutrition, blood glucose and inflammation in an Indonesian population with limited access to dental care. Greater bone loss was associated with higher levels of periodontal bacteria and systemic inflammation, alongside lower body mass index and less frequent guava consumption. No significant association with HbA1c was identified.
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Diabetes mellitus (DM) is a significant global health challenge, with Type 2 diabete mellitus (T2DM) often going undiagnosed for years. It is estimated that 46% of diabetes cases worldwide remain undiagnosed, contributing to delayed treatment and increased complications.
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In rats with newly induced diabetes, surgically created periodontal defects healed poorly. A single application of fibroblast growth factor-2 (FGF-2 – a signalling protein that drives cell growth and blood-vessel formation) mixed with a carrier gel produced more new bone, thicker bone trabeculae (the fine internal beams of spongy bone), less unwanted downgrowth of gum epithelium into the defect, and better-quality blood vessels. However, it did not restore new cementum, indicating that a single dose is not enough for full periodontal regeneration in diabetes.
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Diabetes mellitus (DM) is a common condition linked to systemic and oral complications, including periodontitis, with evidence of a bidirectional relationship between the two.
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Periodontitis, a chronic inflammatory condition affecting tooth-supporting structures, is increasingly recognised as influencing systemic health. Evidence links periodontitis with cardiovascular disease (CVD), atherosclerosis, and metabolic disorders, such as diabetes. The disease’s systemic effects may stem from persistent low-grade inflammation and the spread of oral bacteria and pro-inflammatory cytokines into circulation. Elevated markers like high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6) are shared by periodontitis and atherosclerosis.
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Inflammation plays a pivotal role in cardiovascular disease (CVD) progression, particularly in patients with diabetes mellitus (DM) and periodontitis, which share risk factors and systemic inflammatory pathways.
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Metabolic syndrome (MetS) is a cluster of risk factors, including insulin resistance and obesity, which increases the risk for cardiovascular diseases and type 2 diabetes. Its prevalence varies globally, influenced by factors such as gender, country, and ethnicity. In the United States, about 25% of adults over 20 and 40% of older adults are affected. In Europe, prevalence ranges from 7% to 36% in men and 5% to 22% in women, depending on the study and population. Rapid economic changes in countries like China have seen a rise in MetS, largely due to increasing obesity rates.
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Periodontitis is a chronic inflammatory disease affecting the supporting structures of the teeth, leading to progressive periodontal tissue destruction and eventual tooth loss if untreated. The main aetiological factor for periodontitis is plaque. However, the two main risk factors for progression of the disease have been identified as smoking and diabetes.
Read more
Type 1 Diabetes Mellitus (T1DM) is associated with systemic inflammation, which may worsen oral health. Periodontitis, a chronic inflammatory condition leading to gum and bone loss, has been linked to worse glycaemic control.
Read more
Periodontitis is a chronic inflammatory disease affecting the supporting structures of the teeth, leading to progressive periodontal tissue destruction and eventual tooth loss if untreated. The main aetiological factor for periodontitis is plaque. However, the two main risk factors for progression of the disease have been identified as smoking and diabetes.
Read more
Periodontitis is a chronic inflammatory disease affecting tooth-supporting tissues, driven by pathogenic plaque biofilm and a hyper-inflammatory host response. It leads to periodontal pocket formation, tissue destruction, and potential tooth loss. Individuals with Type 2 diabetes face an increased risk and severity of periodontitis due to their predisposition to oxidative stress and inflammation.
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Insulin resistance, a condition where cells fail to respond effectively to insulin, is central to metabolic disorders like type 2 diabetes and cardiovascular disease. It often leads to systemic low-grade inflammation, a feature shared with periodontal disease, suggesting a potential biological link between these conditions.
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Periodontitis and diabetes share a bidirectional relationship, where poor glycaemic control exacerbates periodontal disease and vice versa. The interplay between periodontal inflammation and glycaemic status is mediated by immune cells, primarily T-helper (Th) cells, which regulate pro- and anti-inflammatory cytokine production.
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Periodontal disease and type 2 diabetes mellitus (T2DM) are interrelated, with evidence suggesting that periodontal disease worsens diabetic control and, conversely, that managing periodontal disease can improve glycaemic control. The host inflammatory response plays a key role in increasing susceptibility to periodontal disease, particularly in individuals with systemic conditions like T2DM. Studies show that individuals with severe periodontitis experience more diabetes-related complications and have poorer HbA1c levels over time. The Gullah population of coastal South Carolina and Georgia, descendants of enslaved Africans, is particularly affected by T2DM due to their genetic predisposition and social isolation. The Gullah have a higher prevalence of chronic diseases, including obesity and hypertension, compared to other populations. Notably, periodontal disease is more prevalent among Gullah individuals with T2DM (70.6%) compared to national estimates for African Americans with diabetes (31.3%). This study aimed to explore the relationship between glycaemic control and periodontal disease progression in Gullah individuals with T2DM.
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Diabetes poses a significant public health burden globally, with prevalence expected to rise sharply, especially in urbanizing areas of developing countries.
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Periodontitis, an inflammatory disease causing tissue destruction of the tissues surrounding teeth, may influence systemic inflammation, particularly in individuals with diabetes.
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Welcome to the Research Hub – your go-to source for concise, digestible summaries of the latest research on the connection between periodontitis and diabetes. Explore key findings on topics such as how periodontal inflammation affects glycaemic control and the benefits of periodontal treatment.
Our summaries provide quick insights, but they are not exhaustive. For a complete understanding of each study’s methodology, results, and implications, we encourage you to review the original research articles. Please note that the Periodontitis-Diabetes hub is not responsible for inaccuracies or misinterpretations of condensed content.
For more guidance on understanding research, including how to interpret studies and evaluate their findings, visit the ‘Colgate Professional Website’ and search for ‘Understanding Research in Dentistry.’
Dive into the science and uncover the powerful link between oral and systemic health!
In a mouse model of type 2 diabetes, experimentally induced gum disease worsened diabetic nephropathy (DN — kidney damage caused by diabetes) by activating an enzyme–hormone pathway (HPGDS–PGD2) inside the kidney’s filtering units (glomeruli). Blocking this pathway with a drug protected the kidneys. A small clinical study in patients suggested a possible link between urinary HPGDS, kidney function and gum disease.
Read more
This study in mice found that diabetes-related changes in gut bacteria weakened the gut’s protective lining and increased oxidative stress, worsening gum inflammation and bone loss. Restoring healthier gut bacteria, protecting the gut lining or giving oleic acid reduced this damage, but studies in people are needed to confirm these benefits.
Read more
Periodontitis is associated with systemic inflammation and has been linked to chronic kidney disease and diabetes. This randomised trial examined whether non-surgical periodontal treatment improves kidney function, systemic inflammation and blood glucose control in patients with chronic kidney disease.
Read more
A combination of bacteria and inflammatory markers in saliva distinguished participants with type 2 diabetes and periodontitis from systemically healthy participants without periodontitis, with reported accuracy of 95%. Further testing is needed to establish whether it can reliably identify gum disease within the diabetic population.
Read more
In mice, butyrate (a substance produced by gut bacteria) reduced diabetes-associated periodontal damage and restored the balance between two types of immune cells. Whether this approach benefits people remains unproven.
Read more
Adding Limosilactobacillus reuteri probiotics to periodontal treatment did not provide additional improvements in gum health or overall bacterial outcomes in patients with diabetes. A possible improvement in blood glucose control was observed, but it was not statistically significant in a separate analysis excluding participants with protocol deviations.
Read more
In a large Swedish register-based study of nearly 19,000 people with dental implants, both type 1 diabetes (T1DM) and type 2 diabetes (T2DM) were associated with a higher risk of peri-implantitis (inflammation and progressive bone loss around a dental implant). The link was clearest for T1DM, particularly when blood-sugar control was poor.
Read more
In diabetic mice, oxidative stress (an imbalance between damaging free radicals and the body’s antioxidant defences) and gut dysbiosis (an unhealthy shift in gut bacteria) appear to fuel each other, worsening periodontitis (inflammatory destruction of the tissues supporting the teeth). Both an antioxidant (curcumin) and faecal microbiota transplantation (FMT — transfer of stool bacteria from a healthy donor) reduced this damage.
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In a mouse model of type 2 diabetes, experimentally induced gum disease worsened diabetic nephropathy (DN — kidney damage caused by diabetes) by activating an enzyme–hormone pathway (HPGDS–PGD2) inside the kidney’s filtering units (glomeruli). Blocking this pathway with a drug protected the kidneys. A small clinical study in patients suggested a possible link between urinary HPGDS, kidney function and gum disease.
Read more
In 43 patients with metabolic syndrome, a 5–10-day medically supervised prolonged fast was associated with lower gum inflammation, less plaque and small, selective shifts in oral bacteria. The overall oral microbiome remained largely stable.
Read more
In a nationwide Japanese cohort of 99,273 middle-aged adults with type 2 diabetes mellitus (T2DM), those who attended a dentist for periodontal care had a 32%–47% lower risk of starting dialysis (a treatment that filters the blood when the kidneys fail) than those with no dental attendance. More frequent visits were linked to greater risk reduction, suggesting that routine gum care may help protect kidney function in diabetes, although the study is observational and cannot prove cause.
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Type 2 diabetes mellitus (T2DM) is a growing global health issue, with millions remaining undiagnosed.In Singapore, diabetes prevalence is among the highest in Southeast Asia, with half of those affected unaware of their condition at diagnosis.
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In 104 pregnant women, extracellular vesicles (EVs — tiny membrane-wrapped particles released by cells and bacteria that carry proteins and other molecules) collected from the gum crevice were more abundant, and had a distinctive surface-marker profile, in women with both periodontitis and gestational diabetes mellitus (GDM). Their protein cargo pointed to roles in immune inflammation, glucose metabolism and insulin response, and included virulence factors from periodontal bacteria – supporting the idea that gum-derived EVs may biologically link periodontitis and GDM.
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Higher dietary quality was associated with differences in subgingival bacterial diversity and a more favourable balance of disease-associated to health-associated bacteria. These observational findings suggest a possible link between diet and the periodontal microbiome, rather than demonstrating a treatment effect.
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Periodontitis was associated with a higher incidence of cardiovascular events or death over approximately 10 years, after adjustment for age, smoking and diabetes.
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Higher oral microbiome diversity was associated with lower all-cause mortality over approximately 9-years. Associations were also observed in participants with diabetes and hypertension, although these findings do not establish causality.
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Experimentally induced diabetes increased peri-implant bone loss, inflammation and connective-tissue disruption in mice. The findings provide biological evidence of diabetes-related susceptibility, but do not establish the magnitude of risk in humans.
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Higher cardiovascular health scores were associated with lower odds of periodontitis in US adults. The association was more pronounced for health behaviours, particularly nicotine exposure, than for physiological health factors.
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Periodontitis affects up to 45% of adults in the United States (US) and has been significantly associated with various systemic health conditions such as diabetes and cardiovascular disease. Current research suggests that periodontal disease may not only impact oral health but also influence overall mortality.
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Periodontitis is a chronic inflammatory disease affecting the supporting structures of the teeth, leading to progressive periodontal tissue destruction and eventual tooth loss if untreated. The main aetiological factor for periodontitis is plaque. However, the two main risk factors for progression of the disease have been identified as smoking and diabetes.
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Periodontal disease is commonly seen in individuals with diabetes, particularly with Type 2 diabetes mellitus (T2DM). The chronic inflammation associated with periodontal disease can exacerbate glycaemic control issues and contribute to the progression of diabetes. There is increased evidence regarding the bidirectional relationship between periodontitis and diabetes. Poor glycaemic control can worsen periodontal health, while periodontitis can further impair glycaemic control, creating a vicious cycle.
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Type 2 diabetes mellitus (T2DM) is a metabolic condition characterised by elevated blood sugar levels due to insufficient insulin function. Effective glycaemic control is crucial for minimising the risk of both microvascular and macrovascular complications. Research indicates that even a 1% reduction in HbA1c levels can significantly lower the incidence of related health issues.
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Prediabetes is increasingly recognised as a major public health issue, affecting about 35% of adults in the United States (US), or roughly 88 million people. While it serves as a significant indicator for developing diabetes, prediabetes is reversible, with around 13% of individuals returning to normal glucose levels. Managing risk factors during the prediabetic phase could alleviate the diabetes burden, a leading cause of morbidity and mortality.
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Periodontal breakdown can lead to further damage in nearby tissues if not treated adequately. Extracting a hopeless or non-essential adjacent tooth can enhance the survival of molars that have undergone periodontal treatment.
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Diabetes mellitus (DM) has associated complications, ranging from cardiovascular issues to kidney diseases, which impose a considerable burden on both those living with diabetes and the healthcare system at large. Effective management of blood sugar levels is pivotal in averting these complications and enhancing the overall outlook for individuals with diabetes.
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Diabetes mellitus (DM) is a global health concern, affecting 537 million people worldwide and accounting for 10% of healthcare expenditure in developed countries.
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Supportive periodontal care (SPC) is critical for maintaining periodontal stability and preventing recurrence of periodontitis. Personalising treatment plans is increasingly essential due to varying chronic illnesses and patient capacities. Periodontal breakdown during SPC often necessitates additional active therapy, highlighting the need for robust risk assessment tools.
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Periodontitis, a chronic inflammatory disease affecting the supporting structures of the teeth, has been linked to various systemic health issues, including cardiovascular disease and diabetes. Given the increasing prevalence of both diabetes and periodontal disease, understanding their interplay is crucial for public health.
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The study investigates the association between periodontal diseases and chronic obstructive pulmonary disease (COPD), motivated by emerging evidence suggesting a potential link between oral health and respiratory conditions.
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The study represents a significant contribution to the understanding of long-term outcomes in periodontal treatment, specifically for patients diagnosed with stages III and IV periodontitis. With the ultimate goal of preserving natural teeth for life, the research addresses the critical need for comprehensive data on tooth loss and treatment efficacy over extended periods.
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Diabetes mellitus (DM) is a significant risk factor for periodontal disease, characterised by hyperglycaemia, chronic inflammation, and compromised immune defence. Poorly controlled blood glucose levels increase the prevalence and severity of periodontal disease, impacting the quality of life for affected individuals. Recent research has introduced the concept of ‘inflamm-ageing’- a pro-inflammatory state linked to diabetes that exacerbates tissue damage through macrophage activation.
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There is a well-established bidirectional relationship between periodontitis and diabetes. Individuals with poorly controlled diabetes are at a higher risk of developing periodontal disease due to the effects of hyperglycaemia on immune function and tissue healing. On the other hand, periodontal disease can exacerbate glycaemic control, leading to increased insulin resistance and worsening metabolic outcomes. The systemic inflammation associated with periodontal disease is believed to contribute to the pathophysiology of diabetes, as inflammatory mediators can interfere with insulin signalling pathways.<
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Periodontal disease, a chronic inflammatory condition affecting the supporting structures of teeth, is prevalent among individuals with diabetes, who are often at a heightened risk due to compromised immune responses and metabolic dysregulation. Conversely, poor glycaemic control has been implicated in the progression of periodontal disease, suggesting a bidirectional relationship that warrants further investigation.
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Peri-implant diseases (PIDs), including peri-implant mucositis and peri-implantitis, are significant complications that can arise following dental implant placement. These conditions are characterised by inflammation of the peri-implant tissues, which can lead to implant failure if not managed effectively.
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Periodontal treatment involves a stepwise framework, including non-surgical sub-gingival instrumentation as the cornerstone for managing periodontitis. This reduces gingival inflammation, probing pocket depth (PPD), and clinical attachment loss (CAL) while improving overall health and quality of life. However, non-surgical treatment can induce an acute-phase systemic inflammatory reaction post-operatively, including increased acute-phase proteins, endothelial dysfunction, elevated body temperature, clotting tendencies, and renal function reduction.
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Metabolic syndrome (MetS) is a cluster of conditions—obesity, dyslipidemia, hypertension, and insulin resistance—that significantly increase the risk of diabetes and cardiovascular disease.Periodontitis, a chronic inflammatory disease of the gums, has been linked to systemic inflammation, insulin resistance, and worsening glycaemic control.
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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.
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Periodontitis, a chronic inflammatory condition, is a leading cause of tooth loss in adults and is exacerbated by diabetes-related hyperglycemia.Diabetes promotes periodontal inflammation and disrupts alveolar bone homeostasis, contributing to tissue damage. Alveolar bone homeostasis involves the endocrine system, signaling interactions between bone and immune cells, and mechanically loaded forces. It relies on bone-resorbing osteoclasts, bone-producing osteoblasts, their precursors and immunoregulatory mediators.
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Diabetes mellitus (DM) is a chronic condition where the body fails to produce or effectively use insulin, resulting in elevated blood glucose. Poor glycaemic control in DM patients can lead to severe complications like cardiovascular disease and kidney failure. The glycosylated haemoglobin assay (HbA1c) is a reliable measure of long-term blood sugar control and is linked to the risk of diabetic complications.
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Diabetes mellitus (DM) is a significant global health issue, often remaining undiagnosed during its asymptomatic phase. Timely detection can prevent complications. Given the bidirectional link between diabetes and periodontitis, dental professionals are uniquely positioned to identify undiagnosed hyperglycaemia using periodontal measures.
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Periodontitis is a chronic inflammatory disease leading to the destruction of tooth-supporting tissues and eventual tooth loss if untreated. It is highly prevalent worldwide, affecting 10–60% of populations. Beyond oral health, periodontitis contributes to systemic diseases by allowing pathogens (bacteria) and inflammatory mediators to enter the circulatory system, increasing risks for conditions like diabetes mellitus (DM), cardiovascular diseases, and adverse pregnancy outcomes.
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Tooth loss (TL), a significant outcome of periodontitis, affects patients physiologically and psychologically. Periodontal therapy and patient compliance during supportive periodontal care (SPC) are crucial in reducing TL risk.Studies highlight patient- and tooth-related factors influencing TL, including periodontal bone loss, tooth mobility, furcation involvement (FI), tooth type, and vitality, with FI identified as a major predictor of molar survival.
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Periodontitis (gum disease) is a chronic inflammatory condition affecting the tissues that support teeth. It has been associated with systemic conditions like cardiovascular disease and diabetes.
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Periodontitis is a chronic inflammatory condition that causes gum and bone damage. It is often linked with systemic inflammation and conditions like metabolic syndrome (MetS).
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Diabetes mellitus (DM) accelerates periodontal disease through hyperglycaemia-induced inflamm-ageing, a chronic, low-grade inflammatory state driven by cellular senescence and the senescence-associated secretory phenotype (SASP). Inflamm-aging disrupts gingival defence mechanisms, including epithelial and fibroblast resistance and immune responses to infection.
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Periodontal maintenance (PM) is crucial for preventing the progression of periodontitis and minimising tooth loss after active periodontal treatment (APT). It includes tailored care such as oral hygiene education, scaling, root planing, and tooth polishing. Despite advances in periodontal therapy, factors like age, smoking, diabetes, and compliance with PM visits impact treatment outcomes.
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Periodontitis is a chronic inflammatory disease causing tissue destruction and tooth loss, often requiring lifelong management. Regular maintenance, termed supportive periodontal therapy (SPT), plays a crucial role in preventing disease progression. The World Workshop (2017) introduced a multidimensional classification for periodontitis, categorising cases into stages (severity) and grades (rate of progression). This study aims to evaluate how the regularity of maintenance visits impacts tooth loss related to periodontitis (TLP) based on staging and grading. It hypothesises that higher disease severity (stages III/IV) and rapid progression (grade C) increase susceptibility to tooth loss, especially with inconsistent maintenance.
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Periodontitis and type 2 diabetes are linked through a bidirectional relationship: diabetes increases the risk and severity of periodontitis, while periodontal inflammation worsens glycaemic control.
Systemic inflammation, driven by cytokines, contributes to complications such as cardiovascular disease and stroke. Associations between severe periodontitis and cardiovascular diseases have also been well-established.
Diabetes mellitus (DM) is a prevalent chronic condition, often undiagnosed, and associated with significant morbidity. Periodontitis is a chronic gum disease linked to systemic inflammation, and dental settings have been proposed as a location for screening undiagnosed DM and prediabetes.
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Periodontitis, a chronic gum disease, involves inflammation and tissue destruction. It is especially common in people living with diabetes, making diagnosis and monitoring crucial.
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Periodontitis has been linked to various systemic diseases, including diabetes, cardiovascular disease, and rheumatoid arthriti
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Partial-mouth protocols (PMPs) are commonly used in population health studies to estimate periodontal disease prevalence, offering a cost-effective and time-efficient alternative to full-mouth protocols (FMPs). However, PMPs are known to underestimate periodontal disease prevalence, which may lead to biases in studies examining associations between periodontitis and systemic conditions like diabetes and cardiovascular disease (CVD).
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Periodontitis, a chronic inflammatory disease caused by bacterial plaque, is associated with systemic conditions such as cardiovascular diseases, diabetes, and adverse pregnancy outcomes. It has also been linked to increased mortality risks
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Periodontal disease, affecting hundreds of millions adults globally, is a leading cause of tooth loss and negatively impacts oral health-related quality of life.
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Inflammation plays a pivotal role in cardiovascular disease (CVD) progression, particularly in patients with diabetes mellitus (DM) and periodontitis, which share risk factors and systemic inflammatory pathways.
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Periodontitis, affecting 11.2% globally, causes tissue destruction, tooth loss, and reduced quality of life. Its bidirectional link with type 2 diabetes mellitus (T2DM) is well-established, with diabetes increasing periodontitis risk and periodontitis worsening glycemic control.
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Periodontitis progression is influenced by common risk factors, including poor oral hygiene, smoking, and lifestyle habits. Interventions targeting these factors can improve treatment outcomes and periodontal health.
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This 12-year study investigated whether periodontitis was associated with changes in blood glucose from early adulthood to age 38. The authors concluded that there was no clear overall association, although 1 analysis identified a small increase in HbA1c in participants with the highest blood glucose trajectory.
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Chronic kidney disease (CKD) involves impaired kidney function, increasing the risk of cardiovascular disease, infection, and mortality. Despite medical advances, CKD prevalence is rising globally.
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A model combining age, gender, ethnicity, smoking and HbA1c identified moderate-to-severe periodontitis with reasonable screening performance. It could help medical professionals identify patients needing periodontal assessment, but requires external validation before wider clinical use.
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Periodontitis and diabetes mellitus (DM) are closely linked, with DM being a significant risk factor for severe periodontitis. Conversely, periodontitis may exacerbate glycaemic management in people living wiith diabetes.
Non-surgical periodontal therapy is an effective treatment to reduce inflammation and improve periodontal health. However, there is uncertainty regarding how diabetes impacts the clinical response to periodontal treatment.
The global rise in type 2 diabetes is a significant contributor to disability and early mortality, often due to vascular and renal complications. Chronic inflammation affects glycaemic control in diabetes, linking it with cardiovascular and kidney diseases. Periodontitis, a prevalent inflammatory condition often co-existing with diabetes, involves an imbalance in oral bacteria and elicits a systemic inflammatory response, raising risks for severe conditions like cardiovascular disease and renal failure. Periodontal therapy aims to manage inflammation through dental cleaning, oral hygiene advice, and possible surgical intervention.
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Most patients retained the majority of their teeth over 20 years after periodontal treatment, with regular maintenance associated with less tooth loss and smoking with greater loss. Diabetes was also associated with tooth loss, but inconsistencies in the reporting prevent a clear interpretation of its effect.
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Diabetes mellitus (DM) is closely associated with periodontitis, with evidence suggesting a bidirectional relationship. While periodontitis may exacerbate systemic inflammation and insulin resistance, periodontal therapy is hypothesised to improve glycaemic management and reduce inflammation in people living with diabetes.
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Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterised by insulin resistance and elevated blood glucose levels, influenced by factors like obesity and inflammation.
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Patients with type 2 diabetes mellitus (T2DM) exhibit higher prevalence and severity of chronic periodontitis compared to individuals without diabetes.
Non-surgical periodontal therapy (NSPT), including scaling and root planing (SRP), has been suggested to improve glycaemic control in T2DM patients.
This study investigated whether 2 microRNAs in gingival crevicular fluid could help identify periodontitis in people with and without type 2 diabetes. Both markers were elevated in periodontitis and decreased after non-surgical treatment, suggesting potential roles in disease assessment and monitoring treatment response.
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The human microbiome plays a vital role in health, with links between gut microbiota and metabolic disorders like type 2 diabetes mellitus (T2DM).The oral microbiota, particularly the subgingival microbiome, is thought to be influenced by diabetes.
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This animal study investigated whether green tea could protect periodontal tissues during prolonged hyperglycaemia in rats with type 1 diabetes. Green tea consumption preserved measures of the small blood vessel network and reduced periodontal destruction, although it did not completely prevent disease.
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Gestational diabetes mellitus (GDM) is a carbohydrate intolerance which begins during pregnancy, with Indian women at significantly higher risk (approximately 11-fold) compared to Caucasians.
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Chronic periodontitis is a common inflammatory disease that causes progressive bone loss and, if untreated, can lead to tooth loss.
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This experimental study investigated how osteocytes (cells embedded within bone) contribute to periodontal bone loss in mice with and without diabetes. Deleting their production of RANKL (a signal that promotes bone breakdown) prevented significant infection-induced bone loss in both groups.
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This human study investigated whether diabetes and smoking were associated with increased levels of proteins that inhibit bone formation in people with periodontitis. Both risk factors were linked to changes in sclerostin and DKK1, suggesting a possible mechanism through which periodontal bone maintenance and repair may be impaired.
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This systematic review examined whether periodontitis was associated with poorer blood glucose control, development of type 2 diabetes and diabetes-related complications. The evidence generally supported these associations, although differences in study quality and methods limited the strength of the conclusions.
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Periodontitis is a widespread condition affecting over half of the global adult population, with prevalence increasing with age.Severe periodontitis is one of the most common human diseases, contributing significantly to tooth loss.
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This preliminary randomised trial investigated whether periodontal treatment changed inflammatory gene expression in blood-derived cells involved in vascular repair in people with type 2 diabetes. Treatment improved periodontal health and reduced IL-6 and IL-8 gene expression, but did not demonstrate corresponding improvements in HbA1c, systemic inflammation or secretion of these proteins.
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This animal study investigated whether activation of the enzyme PARP contributes to the greater periodontal destruction associated with diabetes. Blocking PARP reduced gingival inflammation, nitrosative stress and bone loss in diabetic rats, without significantly changing blood glucose or HbA1c.
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Diabetes mellitus (DM), particularly type 2 (T2DM), is prevalent in the elderly and associated with complications like neuropathy, retinopathy, and cardiovascular issues. Poor glycaemic management exacerbates these complications, significantly affecting quality of life. Periodontitis, a chronic inflammatory disease of the gums, is common in individuals with T2DM. Research indicates a two-way relationship: Periodontitis worsens gum health, while DM elevates systemic inflammation, impairing blood glucose control. In Japan, over half the population aged 40+ years experiences periodontitis. Addressing periodontitis could potentially improve glycaemic management in people with T2DM. This study aimed to assess whether dental visits for periodontal treatment correlate with improved diabetes outcomes in an elderly Japanese cohort.
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There is increasing evidence linking periodontal inflammation to elevated glycated haemoglobin (HbA1c) levels in patients with type 2 diabetes mellitus (T2DM). Periodontal disease is more prevalent in those with T2DM and contributes to chronic inflammation, potentially raising HbA1c levels. Persistently high HbA1c can lead to severe complications such as cardiovascular disease, blindness, amputations, renal failure, and premature death.
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This animal study investigated whether damage to mitochondria (the energy-producing structures within cells) could help explain why diabetes worsens periodontitis. Rats with both conditions showed greater periodontal destruction, increased mitochondrial oxidative stress and reduced cellular energy availability compared with rats with periodontitis alone.
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This Canadian population study examined whether previously unrecognised blood glucose abnormalities and other cardiometabolic risk factors were associated with periodontitis. Elevated fasting glucose was associated with higher odds of periodontitis, but this association was no longer statistically significant after accounting for household income and education.
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Pre-diabetes was associated with greater gum bleeding and severe periodontitis in adults without diabetes. Insulin resistance was associated with bleeding, but its association with severe periodontitis did not reach statistical significance.
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Diabetes risk and insulin resistance are associated with chronic systemic inflammation, often exacerbated by microbial factors. Inflammation interferes with insulin signalling, increasing diabetes susceptibility. Periodontitis, a chronic infection of the tooth-supporting structures, is linked to systemic inflammation and glucose intolerance. Emerging research suggests that early microbial changes in the subgingival environment may play a pivotal role in insulin resistance. The study aimed to investigate the relationship between subgingival bacterial composition, systemic inflammation, and insulin resistance in individuals living without diabetes. The hypothesis posited that dysbiosis (bacterial imbalances) in the subgingival microbiome would correlate with elevated inflammation and insulin resistance markers and that systemic inflammation would mediate this relationship. By identifying specific microbial signatures linked to inflammation and glucose regulation, the study hoped to improve early detection of diabetes risks and inform future intervention strategies.
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Repeated antimicrobial photodynamic therapy and oral doxycycline, each combined with periodontal cleaning, improved periodontal measures and HbA1c over 3-months. Photodynamic therapy showed advantages for certain moderate-depth pockets, but neither treatment produced a significantly greater improvement in glycaemic control.
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Chronic kidney disease (CKD) affects 8–13% of the global population and is linked to higher mortality, primarily from cardiovascular disease (CVD).Systemic inflammation is a key non-traditional risk factor in CKD.
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This animal study investigated whether blocking the inflammatory protein TNF-α could improve periodontal and metabolic outcomes in obese diabetic rats. Etanercept reduced markers of insulin resistance and appeared to lessen diabetes-associated periodontal destruction, while periodontitis itself did not significantly worsen the measured metabolic or kidney outcomes.
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This study examined whether periodontitis and its treatment were associated with changes in parathyroid hormone and active vitamin D. In patients with type 1 diabetes, parathyroid hormone increased after periodontal treatment, particularly in those with more severe disease, but its changes did not consistently track changes in active vitamin D.
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Gestational diabetes mellitus (GDM) and periodontal inflammation are independently associated with adverse pregnancy outcomes, including preterm birth, preeclampsia, and low birth weight.
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Severe periodontitis was associated with wider retinal venules (the small vessels carrying blood away from the retina). The association was significant in participants with diabetes, but not in those without diabetes.
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This study examined the relationship between periodontal bone loss, nutrition, blood glucose and inflammation in an Indonesian population with limited access to dental care. Greater bone loss was associated with higher levels of periodontal bacteria and systemic inflammation, alongside lower body mass index and less frequent guava consumption. No significant association with HbA1c was identified.
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Diabetes mellitus (DM) is a significant global health challenge, with Type 2 diabete mellitus (T2DM) often going undiagnosed for years. It is estimated that 46% of diabetes cases worldwide remain undiagnosed, contributing to delayed treatment and increased complications.
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In rats with newly induced diabetes, surgically created periodontal defects healed poorly. A single application of fibroblast growth factor-2 (FGF-2 – a signalling protein that drives cell growth and blood-vessel formation) mixed with a carrier gel produced more new bone, thicker bone trabeculae (the fine internal beams of spongy bone), less unwanted downgrowth of gum epithelium into the defect, and better-quality blood vessels. However, it did not restore new cementum, indicating that a single dose is not enough for full periodontal regeneration in diabetes.
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Diabetes mellitus (DM) is a common condition linked to systemic and oral complications, including periodontitis, with evidence of a bidirectional relationship between the two.
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Periodontitis, a chronic inflammatory condition affecting tooth-supporting structures, is increasingly recognised as influencing systemic health. Evidence links periodontitis with cardiovascular disease (CVD), atherosclerosis, and metabolic disorders, such as diabetes. The disease’s systemic effects may stem from persistent low-grade inflammation and the spread of oral bacteria and pro-inflammatory cytokines into circulation. Elevated markers like high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6) are shared by periodontitis and atherosclerosis.
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Inflammation plays a pivotal role in cardiovascular disease (CVD) progression, particularly in patients with diabetes mellitus (DM) and periodontitis, which share risk factors and systemic inflammatory pathways.
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Metabolic syndrome (MetS) is a cluster of risk factors, including insulin resistance and obesity, which increases the risk for cardiovascular diseases and type 2 diabetes. Its prevalence varies globally, influenced by factors such as gender, country, and ethnicity. In the United States, about 25% of adults over 20 and 40% of older adults are affected. In Europe, prevalence ranges from 7% to 36% in men and 5% to 22% in women, depending on the study and population. Rapid economic changes in countries like China have seen a rise in MetS, largely due to increasing obesity rates.
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Periodontitis is a chronic inflammatory disease affecting the supporting structures of the teeth, leading to progressive periodontal tissue destruction and eventual tooth loss if untreated. The main aetiological factor for periodontitis is plaque. However, the two main risk factors for progression of the disease have been identified as smoking and diabetes.
Read more
Type 1 Diabetes Mellitus (T1DM) is associated with systemic inflammation, which may worsen oral health. Periodontitis, a chronic inflammatory condition leading to gum and bone loss, has been linked to worse glycaemic control.
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Periodontitis is a chronic inflammatory disease affecting the supporting structures of the teeth, leading to progressive periodontal tissue destruction and eventual tooth loss if untreated. The main aetiological factor for periodontitis is plaque. However, the two main risk factors for progression of the disease have been identified as smoking and diabetes.
Read more
Periodontitis is a chronic inflammatory disease affecting tooth-supporting tissues, driven by pathogenic plaque biofilm and a hyper-inflammatory host response. It leads to periodontal pocket formation, tissue destruction, and potential tooth loss. Individuals with Type 2 diabetes face an increased risk and severity of periodontitis due to their predisposition to oxidative stress and inflammation.
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Insulin resistance, a condition where cells fail to respond effectively to insulin, is central to metabolic disorders like type 2 diabetes and cardiovascular disease. It often leads to systemic low-grade inflammation, a feature shared with periodontal disease, suggesting a potential biological link between these conditions.
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Periodontitis and diabetes share a bidirectional relationship, where poor glycaemic control exacerbates periodontal disease and vice versa. The interplay between periodontal inflammation and glycaemic status is mediated by immune cells, primarily T-helper (Th) cells, which regulate pro- and anti-inflammatory cytokine production.
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Periodontal disease and type 2 diabetes mellitus (T2DM) are interrelated, with evidence suggesting that periodontal disease worsens diabetic control and, conversely, that managing periodontal disease can improve glycaemic control. The host inflammatory response plays a key role in increasing susceptibility to periodontal disease, particularly in individuals with systemic conditions like T2DM. Studies show that individuals with severe periodontitis experience more diabetes-related complications and have poorer HbA1c levels over time. The Gullah population of coastal South Carolina and Georgia, descendants of enslaved Africans, is particularly affected by T2DM due to their genetic predisposition and social isolation. The Gullah have a higher prevalence of chronic diseases, including obesity and hypertension, compared to other populations. Notably, periodontal disease is more prevalent among Gullah individuals with T2DM (70.6%) compared to national estimates for African Americans with diabetes (31.3%). This study aimed to explore the relationship between glycaemic control and periodontal disease progression in Gullah individuals with T2DM.
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Diabetes poses a significant public health burden globally, with prevalence expected to rise sharply, especially in urbanizing areas of developing countries.
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Periodontitis, an inflammatory disease causing tissue destruction of the tissues surrounding teeth, may influence systemic inflammation, particularly in individuals with diabetes.
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Welcome to the Research Hub – your go-to source for concise, digestible summaries of the latest research on the connection between periodontitis and diabetes. Explore key findings on topics such as how periodontal inflammation affects glycaemic control and the benefits of periodontal treatment.
Our summaries provide quick insights, but they are not exhaustive. For a complete understanding of each study’s methodology, results, and implications, we encourage you to review the original research articles. Please note that the Periodontitis-Diabetes hub is not responsible for inaccuracies or misinterpretations of condensed content.
For more guidance on understanding research, including how to interpret studies and evaluate their findings, visit the ‘Colgate Professional Website’ and search for ‘Understanding Research in Dentistry.’
Dive into the science and uncover the powerful link between oral and systemic health!
In a mouse model of type 2 diabetes, experimentally induced gum disease worsened diabetic nephropathy (DN — kidney damage caused by diabetes) by activating an enzyme–hormone pathway (HPGDS–PGD2) inside the kidney’s filtering units (glomeruli). Blocking this pathway with a drug protected the kidneys. A small clinical study in patients suggested a possible link between urinary HPGDS, kidney function and gum disease.
Read more
This study in mice found that diabetes-related changes in gut bacteria weakened the gut’s protective lining and increased oxidative stress, worsening gum inflammation and bone loss. Restoring healthier gut bacteria, protecting the gut lining or giving oleic acid reduced this damage, but studies in people are needed to confirm these benefits.
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Periodontitis is associated with systemic inflammation and has been linked to chronic kidney disease and diabetes. This randomised trial examined whether non-surgical periodontal treatment improves kidney function, systemic inflammation and blood glucose control in patients with chronic kidney disease.
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A combination of bacteria and inflammatory markers in saliva distinguished participants with type 2 diabetes and periodontitis from systemically healthy participants without periodontitis, with reported accuracy of 95%. Further testing is needed to establish whether it can reliably identify gum disease within the diabetic population.
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In mice, butyrate (a substance produced by gut bacteria) reduced diabetes-associated periodontal damage and restored the balance between two types of immune cells. Whether this approach benefits people remains unproven.
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Adding Limosilactobacillus reuteri probiotics to periodontal treatment did not provide additional improvements in gum health or overall bacterial outcomes in patients with diabetes. A possible improvement in blood glucose control was observed, but it was not statistically significant in a separate analysis excluding participants with protocol deviations.
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In a large Swedish register-based study of nearly 19,000 people with dental implants, both type 1 diabetes (T1DM) and type 2 diabetes (T2DM) were associated with a higher risk of peri-implantitis (inflammation and progressive bone loss around a dental implant). The link was clearest for T1DM, particularly when blood-sugar control was poor.
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In diabetic mice, oxidative stress (an imbalance between damaging free radicals and the body’s antioxidant defences) and gut dysbiosis (an unhealthy shift in gut bacteria) appear to fuel each other, worsening periodontitis (inflammatory destruction of the tissues supporting the teeth). Both an antioxidant (curcumin) and faecal microbiota transplantation (FMT — transfer of stool bacteria from a healthy donor) reduced this damage.
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In a mouse model of type 2 diabetes, experimentally induced gum disease worsened diabetic nephropathy (DN — kidney damage caused by diabetes) by activating an enzyme–hormone pathway (HPGDS–PGD2) inside the kidney’s filtering units (glomeruli). Blocking this pathway with a drug protected the kidneys. A small clinical study in patients suggested a possible link between urinary HPGDS, kidney function and gum disease.
Read more
In 43 patients with metabolic syndrome, a 5–10-day medically supervised prolonged fast was associated with lower gum inflammation, less plaque and small, selective shifts in oral bacteria. The overall oral microbiome remained largely stable.
Read more
In a nationwide Japanese cohort of 99,273 middle-aged adults with type 2 diabetes mellitus (T2DM), those who attended a dentist for periodontal care had a 32%–47% lower risk of starting dialysis (a treatment that filters the blood when the kidneys fail) than those with no dental attendance. More frequent visits were linked to greater risk reduction, suggesting that routine gum care may help protect kidney function in diabetes, although the study is observational and cannot prove cause.
Read more
Type 2 diabetes mellitus (T2DM) is a growing global health issue, with millions remaining undiagnosed.In Singapore, diabetes prevalence is among the highest in Southeast Asia, with half of those affected unaware of their condition at diagnosis.
Read more
In 104 pregnant women, extracellular vesicles (EVs — tiny membrane-wrapped particles released by cells and bacteria that carry proteins and other molecules) collected from the gum crevice were more abundant, and had a distinctive surface-marker profile, in women with both periodontitis and gestational diabetes mellitus (GDM). Their protein cargo pointed to roles in immune inflammation, glucose metabolism and insulin response, and included virulence factors from periodontal bacteria – supporting the idea that gum-derived EVs may biologically link periodontitis and GDM.
Read more
Higher dietary quality was associated with differences in subgingival bacterial diversity and a more favourable balance of disease-associated to health-associated bacteria. These observational findings suggest a possible link between diet and the periodontal microbiome, rather than demonstrating a treatment effect.
Read more
Periodontitis was associated with a higher incidence of cardiovascular events or death over approximately 10 years, after adjustment for age, smoking and diabetes.
Read more
Higher oral microbiome diversity was associated with lower all-cause mortality over approximately 9-years. Associations were also observed in participants with diabetes and hypertension, although these findings do not establish causality.
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Experimentally induced diabetes increased peri-implant bone loss, inflammation and connective-tissue disruption in mice. The findings provide biological evidence of diabetes-related susceptibility, but do not establish the magnitude of risk in humans.
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Higher cardiovascular health scores were associated with lower odds of periodontitis in US adults. The association was more pronounced for health behaviours, particularly nicotine exposure, than for physiological health factors.
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Periodontitis affects up to 45% of adults in the United States (US) and has been significantly associated with various systemic health conditions such as diabetes and cardiovascular disease. Current research suggests that periodontal disease may not only impact oral health but also influence overall mortality.
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Periodontitis is a chronic inflammatory disease affecting the supporting structures of the teeth, leading to progressive periodontal tissue destruction and eventual tooth loss if untreated. The main aetiological factor for periodontitis is plaque. However, the two main risk factors for progression of the disease have been identified as smoking and diabetes.
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Periodontal disease is commonly seen in individuals with diabetes, particularly with Type 2 diabetes mellitus (T2DM). The chronic inflammation associated with periodontal disease can exacerbate glycaemic control issues and contribute to the progression of diabetes. There is increased evidence regarding the bidirectional relationship between periodontitis and diabetes. Poor glycaemic control can worsen periodontal health, while periodontitis can further impair glycaemic control, creating a vicious cycle.
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Type 2 diabetes mellitus (T2DM) is a metabolic condition characterised by elevated blood sugar levels due to insufficient insulin function. Effective glycaemic control is crucial for minimising the risk of both microvascular and macrovascular complications. Research indicates that even a 1% reduction in HbA1c levels can significantly lower the incidence of related health issues.
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Prediabetes is increasingly recognised as a major public health issue, affecting about 35% of adults in the United States (US), or roughly 88 million people. While it serves as a significant indicator for developing diabetes, prediabetes is reversible, with around 13% of individuals returning to normal glucose levels. Managing risk factors during the prediabetic phase could alleviate the diabetes burden, a leading cause of morbidity and mortality.
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Periodontal breakdown can lead to further damage in nearby tissues if not treated adequately. Extracting a hopeless or non-essential adjacent tooth can enhance the survival of molars that have undergone periodontal treatment.
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Diabetes mellitus (DM) has associated complications, ranging from cardiovascular issues to kidney diseases, which impose a considerable burden on both those living with diabetes and the healthcare system at large. Effective management of blood sugar levels is pivotal in averting these complications and enhancing the overall outlook for individuals with diabetes.
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Diabetes mellitus (DM) is a global health concern, affecting 537 million people worldwide and accounting for 10% of healthcare expenditure in developed countries.
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Supportive periodontal care (SPC) is critical for maintaining periodontal stability and preventing recurrence of periodontitis. Personalising treatment plans is increasingly essential due to varying chronic illnesses and patient capacities. Periodontal breakdown during SPC often necessitates additional active therapy, highlighting the need for robust risk assessment tools.
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Periodontitis, a chronic inflammatory disease affecting the supporting structures of the teeth, has been linked to various systemic health issues, including cardiovascular disease and diabetes. Given the increasing prevalence of both diabetes and periodontal disease, understanding their interplay is crucial for public health.
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The study investigates the association between periodontal diseases and chronic obstructive pulmonary disease (COPD), motivated by emerging evidence suggesting a potential link between oral health and respiratory conditions.
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The study represents a significant contribution to the understanding of long-term outcomes in periodontal treatment, specifically for patients diagnosed with stages III and IV periodontitis. With the ultimate goal of preserving natural teeth for life, the research addresses the critical need for comprehensive data on tooth loss and treatment efficacy over extended periods.
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Diabetes mellitus (DM) is a significant risk factor for periodontal disease, characterised by hyperglycaemia, chronic inflammation, and compromised immune defence. Poorly controlled blood glucose levels increase the prevalence and severity of periodontal disease, impacting the quality of life for affected individuals. Recent research has introduced the concept of ‘inflamm-ageing’- a pro-inflammatory state linked to diabetes that exacerbates tissue damage through macrophage activation.
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There is a well-established bidirectional relationship between periodontitis and diabetes. Individuals with poorly controlled diabetes are at a higher risk of developing periodontal disease due to the effects of hyperglycaemia on immune function and tissue healing. On the other hand, periodontal disease can exacerbate glycaemic control, leading to increased insulin resistance and worsening metabolic outcomes. The systemic inflammation associated with periodontal disease is believed to contribute to the pathophysiology of diabetes, as inflammatory mediators can interfere with insulin signalling pathways.<
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Periodontal disease, a chronic inflammatory condition affecting the supporting structures of teeth, is prevalent among individuals with diabetes, who are often at a heightened risk due to compromised immune responses and metabolic dysregulation. Conversely, poor glycaemic control has been implicated in the progression of periodontal disease, suggesting a bidirectional relationship that warrants further investigation.
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Peri-implant diseases (PIDs), including peri-implant mucositis and peri-implantitis, are significant complications that can arise following dental implant placement. These conditions are characterised by inflammation of the peri-implant tissues, which can lead to implant failure if not managed effectively.
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Periodontal treatment involves a stepwise framework, including non-surgical sub-gingival instrumentation as the cornerstone for managing periodontitis. This reduces gingival inflammation, probing pocket depth (PPD), and clinical attachment loss (CAL) while improving overall health and quality of life. However, non-surgical treatment can induce an acute-phase systemic inflammatory reaction post-operatively, including increased acute-phase proteins, endothelial dysfunction, elevated body temperature, clotting tendencies, and renal function reduction.
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Metabolic syndrome (MetS) is a cluster of conditions—obesity, dyslipidemia, hypertension, and insulin resistance—that significantly increase the risk of diabetes and cardiovascular disease.Periodontitis, a chronic inflammatory disease of the gums, has been linked to systemic inflammation, insulin resistance, and worsening glycaemic control.
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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.
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Periodontitis, a chronic inflammatory condition, is a leading cause of tooth loss in adults and is exacerbated by diabetes-related hyperglycemia.Diabetes promotes periodontal inflammation and disrupts alveolar bone homeostasis, contributing to tissue damage. Alveolar bone homeostasis involves the endocrine system, signaling interactions between bone and immune cells, and mechanically loaded forces. It relies on bone-resorbing osteoclasts, bone-producing osteoblasts, their precursors and immunoregulatory mediators.
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Diabetes mellitus (DM) is a chronic condition where the body fails to produce or effectively use insulin, resulting in elevated blood glucose. Poor glycaemic control in DM patients can lead to severe complications like cardiovascular disease and kidney failure. The glycosylated haemoglobin assay (HbA1c) is a reliable measure of long-term blood sugar control and is linked to the risk of diabetic complications.
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Diabetes mellitus (DM) is a significant global health issue, often remaining undiagnosed during its asymptomatic phase. Timely detection can prevent complications. Given the bidirectional link between diabetes and periodontitis, dental professionals are uniquely positioned to identify undiagnosed hyperglycaemia using periodontal measures.
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Periodontitis is a chronic inflammatory disease leading to the destruction of tooth-supporting tissues and eventual tooth loss if untreated. It is highly prevalent worldwide, affecting 10–60% of populations. Beyond oral health, periodontitis contributes to systemic diseases by allowing pathogens (bacteria) and inflammatory mediators to enter the circulatory system, increasing risks for conditions like diabetes mellitus (DM), cardiovascular diseases, and adverse pregnancy outcomes.
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Tooth loss (TL), a significant outcome of periodontitis, affects patients physiologically and psychologically. Periodontal therapy and patient compliance during supportive periodontal care (SPC) are crucial in reducing TL risk.Studies highlight patient- and tooth-related factors influencing TL, including periodontal bone loss, tooth mobility, furcation involvement (FI), tooth type, and vitality, with FI identified as a major predictor of molar survival.
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Periodontitis (gum disease) is a chronic inflammatory condition affecting the tissues that support teeth. It has been associated with systemic conditions like cardiovascular disease and diabetes.
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Periodontitis is a chronic inflammatory condition that causes gum and bone damage. It is often linked with systemic inflammation and conditions like metabolic syndrome (MetS).
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Diabetes mellitus (DM) accelerates periodontal disease through hyperglycaemia-induced inflamm-ageing, a chronic, low-grade inflammatory state driven by cellular senescence and the senescence-associated secretory phenotype (SASP). Inflamm-aging disrupts gingival defence mechanisms, including epithelial and fibroblast resistance and immune responses to infection.
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Periodontal maintenance (PM) is crucial for preventing the progression of periodontitis and minimising tooth loss after active periodontal treatment (APT). It includes tailored care such as oral hygiene education, scaling, root planing, and tooth polishing. Despite advances in periodontal therapy, factors like age, smoking, diabetes, and compliance with PM visits impact treatment outcomes.
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Periodontitis is a chronic inflammatory disease causing tissue destruction and tooth loss, often requiring lifelong management. Regular maintenance, termed supportive periodontal therapy (SPT), plays a crucial role in preventing disease progression. The World Workshop (2017) introduced a multidimensional classification for periodontitis, categorising cases into stages (severity) and grades (rate of progression). This study aims to evaluate how the regularity of maintenance visits impacts tooth loss related to periodontitis (TLP) based on staging and grading. It hypothesises that higher disease severity (stages III/IV) and rapid progression (grade C) increase susceptibility to tooth loss, especially with inconsistent maintenance.
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Periodontitis and type 2 diabetes are linked through a bidirectional relationship: diabetes increases the risk and severity of periodontitis, while periodontal inflammation worsens glycaemic control.
Systemic inflammation, driven by cytokines, contributes to complications such as cardiovascular disease and stroke. Associations between severe periodontitis and cardiovascular diseases have also been well-established.
Diabetes mellitus (DM) is a prevalent chronic condition, often undiagnosed, and associated with significant morbidity. Periodontitis is a chronic gum disease linked to systemic inflammation, and dental settings have been proposed as a location for screening undiagnosed DM and prediabetes.
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Periodontitis, a chronic gum disease, involves inflammation and tissue destruction. It is especially common in people living with diabetes, making diagnosis and monitoring crucial.
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Periodontitis has been linked to various systemic diseases, including diabetes, cardiovascular disease, and rheumatoid arthriti
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Partial-mouth protocols (PMPs) are commonly used in population health studies to estimate periodontal disease prevalence, offering a cost-effective and time-efficient alternative to full-mouth protocols (FMPs). However, PMPs are known to underestimate periodontal disease prevalence, which may lead to biases in studies examining associations between periodontitis and systemic conditions like diabetes and cardiovascular disease (CVD).
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Periodontitis, a chronic inflammatory disease caused by bacterial plaque, is associated with systemic conditions such as cardiovascular diseases, diabetes, and adverse pregnancy outcomes. It has also been linked to increased mortality risks
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Periodontal disease, affecting hundreds of millions adults globally, is a leading cause of tooth loss and negatively impacts oral health-related quality of life.
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Inflammation plays a pivotal role in cardiovascular disease (CVD) progression, particularly in patients with diabetes mellitus (DM) and periodontitis, which share risk factors and systemic inflammatory pathways.
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Periodontitis, affecting 11.2% globally, causes tissue destruction, tooth loss, and reduced quality of life. Its bidirectional link with type 2 diabetes mellitus (T2DM) is well-established, with diabetes increasing periodontitis risk and periodontitis worsening glycemic control.
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Periodontitis progression is influenced by common risk factors, including poor oral hygiene, smoking, and lifestyle habits. Interventions targeting these factors can improve treatment outcomes and periodontal health.
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This 12-year study investigated whether periodontitis was associated with changes in blood glucose from early adulthood to age 38. The authors concluded that there was no clear overall association, although 1 analysis identified a small increase in HbA1c in participants with the highest blood glucose trajectory.
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Chronic kidney disease (CKD) involves impaired kidney function, increasing the risk of cardiovascular disease, infection, and mortality. Despite medical advances, CKD prevalence is rising globally.
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A model combining age, gender, ethnicity, smoking and HbA1c identified moderate-to-severe periodontitis with reasonable screening performance. It could help medical professionals identify patients needing periodontal assessment, but requires external validation before wider clinical use.
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Periodontitis and diabetes mellitus (DM) are closely linked, with DM being a significant risk factor for severe periodontitis. Conversely, periodontitis may exacerbate glycaemic management in people living wiith diabetes.
Non-surgical periodontal therapy is an effective treatment to reduce inflammation and improve periodontal health. However, there is uncertainty regarding how diabetes impacts the clinical response to periodontal treatment.
The global rise in type 2 diabetes is a significant contributor to disability and early mortality, often due to vascular and renal complications. Chronic inflammation affects glycaemic control in diabetes, linking it with cardiovascular and kidney diseases. Periodontitis, a prevalent inflammatory condition often co-existing with diabetes, involves an imbalance in oral bacteria and elicits a systemic inflammatory response, raising risks for severe conditions like cardiovascular disease and renal failure. Periodontal therapy aims to manage inflammation through dental cleaning, oral hygiene advice, and possible surgical intervention.
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Most patients retained the majority of their teeth over 20 years after periodontal treatment, with regular maintenance associated with less tooth loss and smoking with greater loss. Diabetes was also associated with tooth loss, but inconsistencies in the reporting prevent a clear interpretation of its effect.
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Diabetes mellitus (DM) is closely associated with periodontitis, with evidence suggesting a bidirectional relationship. While periodontitis may exacerbate systemic inflammation and insulin resistance, periodontal therapy is hypothesised to improve glycaemic management and reduce inflammation in people living with diabetes.
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Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterised by insulin resistance and elevated blood glucose levels, influenced by factors like obesity and inflammation.
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Patients with type 2 diabetes mellitus (T2DM) exhibit higher prevalence and severity of chronic periodontitis compared to individuals without diabetes.
Non-surgical periodontal therapy (NSPT), including scaling and root planing (SRP), has been suggested to improve glycaemic control in T2DM patients.
This study investigated whether 2 microRNAs in gingival crevicular fluid could help identify periodontitis in people with and without type 2 diabetes. Both markers were elevated in periodontitis and decreased after non-surgical treatment, suggesting potential roles in disease assessment and monitoring treatment response.
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The human microbiome plays a vital role in health, with links between gut microbiota and metabolic disorders like type 2 diabetes mellitus (T2DM).The oral microbiota, particularly the subgingival microbiome, is thought to be influenced by diabetes.
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This animal study investigated whether green tea could protect periodontal tissues during prolonged hyperglycaemia in rats with type 1 diabetes. Green tea consumption preserved measures of the small blood vessel network and reduced periodontal destruction, although it did not completely prevent disease.
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Gestational diabetes mellitus (GDM) is a carbohydrate intolerance which begins during pregnancy, with Indian women at significantly higher risk (approximately 11-fold) compared to Caucasians.
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Chronic periodontitis is a common inflammatory disease that causes progressive bone loss and, if untreated, can lead to tooth loss.
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This experimental study investigated how osteocytes (cells embedded within bone) contribute to periodontal bone loss in mice with and without diabetes. Deleting their production of RANKL (a signal that promotes bone breakdown) prevented significant infection-induced bone loss in both groups.
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This human study investigated whether diabetes and smoking were associated with increased levels of proteins that inhibit bone formation in people with periodontitis. Both risk factors were linked to changes in sclerostin and DKK1, suggesting a possible mechanism through which periodontal bone maintenance and repair may be impaired.
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This systematic review examined whether periodontitis was associated with poorer blood glucose control, development of type 2 diabetes and diabetes-related complications. The evidence generally supported these associations, although differences in study quality and methods limited the strength of the conclusions.
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Periodontitis is a widespread condition affecting over half of the global adult population, with prevalence increasing with age.Severe periodontitis is one of the most common human diseases, contributing significantly to tooth loss.
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This preliminary randomised trial investigated whether periodontal treatment changed inflammatory gene expression in blood-derived cells involved in vascular repair in people with type 2 diabetes. Treatment improved periodontal health and reduced IL-6 and IL-8 gene expression, but did not demonstrate corresponding improvements in HbA1c, systemic inflammation or secretion of these proteins.
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This animal study investigated whether activation of the enzyme PARP contributes to the greater periodontal destruction associated with diabetes. Blocking PARP reduced gingival inflammation, nitrosative stress and bone loss in diabetic rats, without significantly changing blood glucose or HbA1c.
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Diabetes mellitus (DM), particularly type 2 (T2DM), is prevalent in the elderly and associated with complications like neuropathy, retinopathy, and cardiovascular issues. Poor glycaemic management exacerbates these complications, significantly affecting quality of life. Periodontitis, a chronic inflammatory disease of the gums, is common in individuals with T2DM. Research indicates a two-way relationship: Periodontitis worsens gum health, while DM elevates systemic inflammation, impairing blood glucose control. In Japan, over half the population aged 40+ years experiences periodontitis. Addressing periodontitis could potentially improve glycaemic management in people with T2DM. This study aimed to assess whether dental visits for periodontal treatment correlate with improved diabetes outcomes in an elderly Japanese cohort.
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There is increasing evidence linking periodontal inflammation to elevated glycated haemoglobin (HbA1c) levels in patients with type 2 diabetes mellitus (T2DM). Periodontal disease is more prevalent in those with T2DM and contributes to chronic inflammation, potentially raising HbA1c levels. Persistently high HbA1c can lead to severe complications such as cardiovascular disease, blindness, amputations, renal failure, and premature death.
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This animal study investigated whether damage to mitochondria (the energy-producing structures within cells) could help explain why diabetes worsens periodontitis. Rats with both conditions showed greater periodontal destruction, increased mitochondrial oxidative stress and reduced cellular energy availability compared with rats with periodontitis alone.
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This Canadian population study examined whether previously unrecognised blood glucose abnormalities and other cardiometabolic risk factors were associated with periodontitis. Elevated fasting glucose was associated with higher odds of periodontitis, but this association was no longer statistically significant after accounting for household income and education.
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Pre-diabetes was associated with greater gum bleeding and severe periodontitis in adults without diabetes. Insulin resistance was associated with bleeding, but its association with severe periodontitis did not reach statistical significance.
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Diabetes risk and insulin resistance are associated with chronic systemic inflammation, often exacerbated by microbial factors. Inflammation interferes with insulin signalling, increasing diabetes susceptibility. Periodontitis, a chronic infection of the tooth-supporting structures, is linked to systemic inflammation and glucose intolerance. Emerging research suggests that early microbial changes in the subgingival environment may play a pivotal role in insulin resistance. The study aimed to investigate the relationship between subgingival bacterial composition, systemic inflammation, and insulin resistance in individuals living without diabetes. The hypothesis posited that dysbiosis (bacterial imbalances) in the subgingival microbiome would correlate with elevated inflammation and insulin resistance markers and that systemic inflammation would mediate this relationship. By identifying specific microbial signatures linked to inflammation and glucose regulation, the study hoped to improve early detection of diabetes risks and inform future intervention strategies.
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Repeated antimicrobial photodynamic therapy and oral doxycycline, each combined with periodontal cleaning, improved periodontal measures and HbA1c over 3-months. Photodynamic therapy showed advantages for certain moderate-depth pockets, but neither treatment produced a significantly greater improvement in glycaemic control.
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Chronic kidney disease (CKD) affects 8–13% of the global population and is linked to higher mortality, primarily from cardiovascular disease (CVD).Systemic inflammation is a key non-traditional risk factor in CKD.
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This animal study investigated whether blocking the inflammatory protein TNF-α could improve periodontal and metabolic outcomes in obese diabetic rats. Etanercept reduced markers of insulin resistance and appeared to lessen diabetes-associated periodontal destruction, while periodontitis itself did not significantly worsen the measured metabolic or kidney outcomes.
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This study examined whether periodontitis and its treatment were associated with changes in parathyroid hormone and active vitamin D. In patients with type 1 diabetes, parathyroid hormone increased after periodontal treatment, particularly in those with more severe disease, but its changes did not consistently track changes in active vitamin D.
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Gestational diabetes mellitus (GDM) and periodontal inflammation are independently associated with adverse pregnancy outcomes, including preterm birth, preeclampsia, and low birth weight.
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Severe periodontitis was associated with wider retinal venules (the small vessels carrying blood away from the retina). The association was significant in participants with diabetes, but not in those without diabetes.
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This study examined the relationship between periodontal bone loss, nutrition, blood glucose and inflammation in an Indonesian population with limited access to dental care. Greater bone loss was associated with higher levels of periodontal bacteria and systemic inflammation, alongside lower body mass index and less frequent guava consumption. No significant association with HbA1c was identified.
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Diabetes mellitus (DM) is a significant global health challenge, with Type 2 diabete mellitus (T2DM) often going undiagnosed for years. It is estimated that 46% of diabetes cases worldwide remain undiagnosed, contributing to delayed treatment and increased complications.
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In rats with newly induced diabetes, surgically created periodontal defects healed poorly. A single application of fibroblast growth factor-2 (FGF-2 – a signalling protein that drives cell growth and blood-vessel formation) mixed with a carrier gel produced more new bone, thicker bone trabeculae (the fine internal beams of spongy bone), less unwanted downgrowth of gum epithelium into the defect, and better-quality blood vessels. However, it did not restore new cementum, indicating that a single dose is not enough for full periodontal regeneration in diabetes.
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Diabetes mellitus (DM) is a common condition linked to systemic and oral complications, including periodontitis, with evidence of a bidirectional relationship between the two.
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Periodontitis, a chronic inflammatory condition affecting tooth-supporting structures, is increasingly recognised as influencing systemic health. Evidence links periodontitis with cardiovascular disease (CVD), atherosclerosis, and metabolic disorders, such as diabetes. The disease’s systemic effects may stem from persistent low-grade inflammation and the spread of oral bacteria and pro-inflammatory cytokines into circulation. Elevated markers like high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6) are shared by periodontitis and atherosclerosis.
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Inflammation plays a pivotal role in cardiovascular disease (CVD) progression, particularly in patients with diabetes mellitus (DM) and periodontitis, which share risk factors and systemic inflammatory pathways.
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Metabolic syndrome (MetS) is a cluster of risk factors, including insulin resistance and obesity, which increases the risk for cardiovascular diseases and type 2 diabetes. Its prevalence varies globally, influenced by factors such as gender, country, and ethnicity. In the United States, about 25% of adults over 20 and 40% of older adults are affected. In Europe, prevalence ranges from 7% to 36% in men and 5% to 22% in women, depending on the study and population. Rapid economic changes in countries like China have seen a rise in MetS, largely due to increasing obesity rates.
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Periodontitis is a chronic inflammatory disease affecting the supporting structures of the teeth, leading to progressive periodontal tissue destruction and eventual tooth loss if untreated. The main aetiological factor for periodontitis is plaque. However, the two main risk factors for progression of the disease have been identified as smoking and diabetes.
Read more
Type 1 Diabetes Mellitus (T1DM) is associated with systemic inflammation, which may worsen oral health. Periodontitis, a chronic inflammatory condition leading to gum and bone loss, has been linked to worse glycaemic control.
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Periodontitis is a chronic inflammatory disease affecting the supporting structures of the teeth, leading to progressive periodontal tissue destruction and eventual tooth loss if untreated. The main aetiological factor for periodontitis is plaque. However, the two main risk factors for progression of the disease have been identified as smoking and diabetes.
Read more
Periodontitis is a chronic inflammatory disease affecting tooth-supporting tissues, driven by pathogenic plaque biofilm and a hyper-inflammatory host response. It leads to periodontal pocket formation, tissue destruction, and potential tooth loss. Individuals with Type 2 diabetes face an increased risk and severity of periodontitis due to their predisposition to oxidative stress and inflammation.
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Insulin resistance, a condition where cells fail to respond effectively to insulin, is central to metabolic disorders like type 2 diabetes and cardiovascular disease. It often leads to systemic low-grade inflammation, a feature shared with periodontal disease, suggesting a potential biological link between these conditions.
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Periodontitis and diabetes share a bidirectional relationship, where poor glycaemic control exacerbates periodontal disease and vice versa. The interplay between periodontal inflammation and glycaemic status is mediated by immune cells, primarily T-helper (Th) cells, which regulate pro- and anti-inflammatory cytokine production.
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Periodontal disease and type 2 diabetes mellitus (T2DM) are interrelated, with evidence suggesting that periodontal disease worsens diabetic control and, conversely, that managing periodontal disease can improve glycaemic control. The host inflammatory response plays a key role in increasing susceptibility to periodontal disease, particularly in individuals with systemic conditions like T2DM. Studies show that individuals with severe periodontitis experience more diabetes-related complications and have poorer HbA1c levels over time. The Gullah population of coastal South Carolina and Georgia, descendants of enslaved Africans, is particularly affected by T2DM due to their genetic predisposition and social isolation. The Gullah have a higher prevalence of chronic diseases, including obesity and hypertension, compared to other populations. Notably, periodontal disease is more prevalent among Gullah individuals with T2DM (70.6%) compared to national estimates for African Americans with diabetes (31.3%). This study aimed to explore the relationship between glycaemic control and periodontal disease progression in Gullah individuals with T2DM.
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Diabetes poses a significant public health burden globally, with prevalence expected to rise sharply, especially in urbanizing areas of developing countries.
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Periodontitis, an inflammatory disease causing tissue destruction of the tissues surrounding teeth, may influence systemic inflammation, particularly in individuals with diabetes.
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Periodontitis is the 6th most prevalent condition globally
Periodontitis and diabetes are bidirectionally linked
Diabetic complications are increased if you have both diseases
Successful periodontal treatment can improve blood glucose control
Periodontitis is the 6th most prevalent condition globally
Periodontitis and diabetes are bidirectionally linked
Diabetic complications are increased if you have both diseases
Successful periodontal treatment can improve blood glucose control
