How are periodontitis and diabetes related?

Veröffentlicht am: October 15, 2024
Dr. med. Wolfgang Bachmann
Dr. med. Wolfgang Bachmann

General practitioner

How are periodontitis and diabetes related? 

New research findings show that periodontitis and diabetes are mutually reinforcing! The question of how these two widespread diseases are linked must first be clarified as to how periodontitis occurs.

How does periodontitis develop?

Every time you eat, small pieces of food stick to your teeth. If these are not removed thoroughly and regularly, plaque builds up. It is precisely this plaque that encourages bacteria to colonize and multiply in our mouth. This throws our entire oral flora out of balance.  

In order to get rid of the bacteria, our body fights them mercilessly with the help of the immune system. This leads to inflammatory reactions in the gums and jawbones. Both recede over time and expose the tooth necks. Gum pockets develop in which the bacteria feel right at home.

If the inflammation continues, it leads to a gum infection - periodontitis. This is a disease of the entire periodontium. Periodontitis causes the gums to detach from the teeth, damaging the gums, bone and teeth. As the disease progresses, it leads to tooth loss and other serious problems.

 

➤ Every 2nd German now suffers from periodontitis!

Periodontitis promotes diabetes

Scientists assume that periodontitis is not only responsible for tooth loss, but also for type 2 diabetes or a heart attack.

  1. Bacteria lead to severe inflammation in the mouth
  2. Reduced effect of insulin due to inflammatory molecules
  3. Blood sugar remains in the blood and blood sugar increases as a result
  4. Increased insulin production and cell exhaustion
  5. Increased risk of insulin resistance and diabetes

Advanced periodontitis leads to severe inflammation in the entire oral cavity. Inflammatory molecules lead to a reduced effect of insulin. The blood sugar is less able to reach its destination - the body cells. Instead, the sugar remains in the blood and blood sugar levels rise. The body tries to compensate for this by increasing insulin production. However, this can lead to the insulin-producing cells in the pancreas becoming exhausted. As a consequence, the risk of insulin resistance and therefore diabetes increases enormously.

This is how non-diabetics develop into pre-diabetics, pre-diabetics into diabetics and well-controlled diabetics into diabetics with poor blood sugar control.

➤ People with periodontitis have twice the risk of developing diabetes!

Current study situation

Studies confirm these statements. A Finnish study from 2018 found that the risk of diabetes was up to 50% higher in subjects suffering from severe periodontitis than in healthy subjects.

Furthermore, scientists assume that periodontitis and diabetes reinforce each other, as diabetes is associated with wound healing disorders.

Research results confirm this. Diabetics are said to be three times more likely to develop periodontitis than healthy people. Periodontitis increases insulin resistance, making it more difficult to control blood sugar levels. In addition, diabetics with periodontitis suffer more frequently from diabetes complications.

 

➤ Diabetics, in turn, have a threefold increased risk of developing periodontitis!

Periodontitis - also a danger to the heart?

Germs in the mouth not only lead to periodontitis, they threaten the entire body, including our heart! If they enter the bloodstream, they can trigger inflammation.

For example, a Korean study showed that people with periodontitis have a 15% higher risk of heart attack, stroke and cardiac death. In comparison, regular tooth brushing reduced the risk of heart attack by 9 %.

Reduce your risk of diabetes and heart attack today

  • Good oral hygiene: It is best to take preventative measures and get rid of plaque at an early stage by brushing your teeth regularly and having them professionally cleaned.
  • Regular check-ups: In addition to thorough oral hygiene, the German Diabetes Society recommends regular visits to the dentist to reduce the risk.
  • Combat inflammation in a targeted manner: Reduce inflammation in your body in a targeted manner, for example with nutritional supplements.
  • Periodontitis therapy: Some scientific studies have shown that effective periodontal treatment can reduce blood sugar levels and alleviate symptoms. Such non-surgical periodontitis therapy therefore has a positive effect on people with type 2 diabetes.

Experts also suggest that diabetes tests should be carried out specifically in dental practices, as around 2 million people in Germany alone are unaware that they have diabetes.

 

Sources (in English):

Correa, F. O., Goncalves, D., Figueredo, C. M., Bastos, A. S., Gustafsson, A. & Orrico, S. R. (2010, January). Effect of periodontal treatment on metabolic control, systemic inflammation and cytokines in patients with type 2 diabetes. Journal of Clinical Perodontology, 37(1):53-8, doi: 10.1111/j.1600-051X.2009.01498.x

Navarro-Sanchez, A. B., Faria-Almeida, R. & Bascones-Martinez, A. (2007, October). Effect of non-surgical periodontal therapy on clinical and immunological response and glycaemic control in type 2 diabetic patients with moderate periodontitis. Journal of Clinical Periodontology, 34(10):835-43, doi: 10.1111/j.1600-051X.2007.01127.x

Thorstensson, H., Kuylenstierna, J. & Hugoson, A. (1996, March). Medical status and complications in relation to periodontal disease experience in insulin-dependent diabetics. Journal of Clinical Periodontology, 23(3 Pt 1):194-202, doi: 10.1111/j.1600-051x.1996.tb02076.x

Taylor, G. W., Burt, B. A., Becker, M. P., Genco, R. J., Chlossman, M., Knowler, W. C. et al. (1996, October). Severe periodontitis and risk for poor glycemic control in patients with non-insulin-dependent diabetes mellitus. Journal of Periodontology, 67(10 Suppl):1085-93, doi: 10.1902/jop.1996.67.10s.1085

Emrich, L. J., Schlossman, M. & Genco, R. J. (1991, February). Periodontal disease in non-insulin-dependent diabetes mellitus. Journal of Periodontolgy, 62(2):123-31, doi: 10.1902/jop.1991.62.2.123

Mullymäki, V., Saxlin, T., Knuutila, M., Rajala, U., Keinänen-Kiukaanniemi, S., Anttila, S. & Ylöstalo, P. (2018, August). Association between periodontal condition and the development of type 2 diabetes mellitus-Results from a 15-year follow-up study. Journal of Clinical Periodontology, Volume 45, Issue 11, doi: 10.1111/jcpe.13005