Periodontal disease and a poor response to periodontal treatment were associated with an increased risk of incident diabetes: A longitudinal cohort study in Sweden

Abstract

Aim: To investigate whether periodontal disease or the response to periodontal treatment could influence the risk of future diabetes.

Materials and methods: The eligible population consisted of 8983 individuals referred for periodontal treatment between 1980 and 2015. Diabetes incidence was obtained from the Swedish registers for cause of death, hospital discharge, and national diabetes registers. Data concerning treatment outcome 1 year after treatment were available for 5258 individuals. Poor response to treatment was defined as having >10% sites with probing pocket depth ≥5 mm and bleeding on probing (BOP) at ≥20% of the sites.

Results: Among the 8983 individuals during a median follow-up of 21.3 years, 1117 cases of diabetes occurred. The number of teeth and BOP at baseline were significantly associated with incident diabetes in a dose-dependent manner after adjusting for age, sex, smoking, education level, and civil status [incident rate ratio (IRR) = 0.88 (95% confidence interval [CI] 0.84-0.93), p < .001 and IRR = 1.06 (95% CI 1.02-1.11), p = .003, respectively]. Poor response to treatment (14%) was associated with an increased risk (37%) for future diabetes (95% CI 1.12-1.68, p = .002) compared with good responders.

Conclusions: Periodontal disease with increased tooth loss and BOP, as well as poor response to treatment, was associated with an increased risk for diabetes.

Keywords: diabetes; oral health; periodontal disease; periodontal treatment; tooth loss.