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New study highlights a bidirectional effect between oral disease and diabetes

Recent research has found that diabetes is the only chronic systemic condition (of those included in the study) associated with oral health and that diabetes and chronic oral disease have detrimental, long-term effects on each other that hinder their treatment. (Image: file404/Shutterstock)

HELSINKI, Finland: In a recent study conducted at the University of Helsinki in Finland, researchers investigated whether oral health abnormalities could precede and/or promote tissue inflammation related to chronic systemic conditions. Through a ten-year follow-up, they found that periodontitis has a strong link with diabetes and reported that the two diseases affect each other. In light of the findings, the study authors argue that general and oral health should be considered as a whole in healthcare.

The study involved 68,273 patients aged 29 years or older with at least one dental visit to the Helsinki city health services between 2001 and 2002. In total, 46,998 of the study population had diabetes. Additionally, about 25% of the participants had periodontitis, 17% had caries, over 70% had periapical periodontitis and 9% had less than 24 teeth at baseline.

“We know from prior studies that periodontitis has a connection to many chronic diseases. Thanks to our exceptionally long-term data set, we were able to analyse causalities and bidirectional effects between these factors,” study co-author Pia Heikkilä, a senior lecturer in the Department of Oral and Maxillofacial Diseases at the University of Helsinki, said in a press release.

“The research data set was unusually extensive, encompassing some 70,000 study subjects, which increases the reliability and weight of the study,” she added.

According to findings, having periodontitis, caries or periapical periodontitis lesions was associated with common metabolic diseases, including metabolic syndrome, Type 1 and 2 diabetes and gestational diabetes. The researchers also found that there was a fairly strong association between the number of decayed teeth and the incidence of diabetes. The researchers did not observe a similar association between any oral health abnormalities and other common chronic diseases, such as rheumatoid arthritis or serious mental disorders.

Considering the findings, they explained that diabetes enhances the progression of periodontitis and complicates its diagnosis and treatment, particularly if diabetes has not been diagnosed or the disease is poorly controlled. Similarly, they noted that incipient or latent periodontitis makes diabetes chronic and impedes its diagnosis, control and maintenance therapy. Additionally, the bidirectional effect between these diseases results in increased economic and healthcare costs, the study authors stated.

“Based on our findings, successful treatment of periodontitis has a positive effect on the treatment outcomes for diabetes and reduces the cost of care. Similarly, the successful treatment of diabetes slows down the progression of periodontitis while reducing medical costs,” commented co-author Dr Timo Sorsa, a professor in the Department of Oral and Maxillofacial Diseases at the university. “The general and oral health of patients should be considered as a whole in healthcare, as our research demonstrates that even latent diseases have a harmful and long-term effect on one another,” Dr Sorsa continued.

“Hopefully, the training of professionals in the field and the healthcare service system in line with the health and social services reform in Finland will enable the collaboration needed for this. It’s in the interest of patients and taxpayers,” he concluded.

According to the International Diabetes Federation, approximately 537 million adults between 20 and 79 years of age had diabetes in 2021, and the number is projected to rise to 643 million by 2030 and 783 million by 2045.

The study, titled “Oral health associated with incident diabetes but not other chronic diseases: A register-based cohort study”, was published online on 18 August 2022 in Frontiers in Oral Health.

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