Review explores relationship between obesity, diabetes and tooth loss
The links between diabetes, obesity and periodontal disease are well established; however, most studies on their associations have had sample sizes of fewer than 10,000 participants. This limits robust analysis of these and other risk factors of tooth loss. A narrative review by researchers at Shiga University of Medical Science in Ōtsu, Japan has leveraged large-scale national data to assess the impact of diabetes and obesity on tooth retention, offering clearer insights into the cyclical relationship between the conditions in relation to tooth loss.
Visceral fat accumulation is known to promote chronic inflammation and insulin resistance — key mechanisms in diabetes. Periodontal inflammation may further contribute to systemic insulin resistance. To better understand the effects of diabetes and obesity on tooth retention, the researchers drew on a large dataset combining dental claim and health check-up data on around 230,000 individuals.
Analysis showed that higher haemoglobin A1c (HbA1c) and fasting glucose levels were associated with fewer remaining teeth. This inverse relationship was evident even among individuals who had not been diagnosed with diabetes and was observable from as early as 30 years of age. Site-specific analysis found that individuals in their thirties with HbA1c levels of ≥7% had a higher risk of posterior tooth loss than those with better glycaemic control. In individuals in their forties and fifties, this trend extended to adjacent and anterior teeth. The researchers said that these findings suggest that inadequate glycaemic control contributes to early posterior tooth loss and that greater tooth loss develops over time.
The study, titled ‘The relationship among obesity, diabetes, and oral health: A narrative review of real-world evidence’, was published online in Current Oral Health Reports.
