Abstract
This Perspective provides a brief summary of the scientific evidence for the often two-way links between hyperglycemia, including manifest diabetes mellitus (DM), and oral health. It delivers in a nutshell examples of current scientific evidence for the following oral manifestations of hyperglycemia, along with any available evidence for effect in the opposite direction: periodontal diseases, caries/periapical periodontitis, tooth loss, peri-implantitis, dry mouth (xerostomia/hyposalivation), dysbiosis in the oral microbiome, candidiasis, taste disturbances, burning mouth syndrome, cancer, traumatic ulcers, infections of oral wounds, delayed wound healing, melanin pigmentation, fissured tongue, benign migratory glossitis (geographic tongue), temporomandibular disorders, and osteonecrosis of the jaw. Evidence for effects on quality of life will also be reported. This condensed overview delivers the rationale and sets the stage for the urgent need for delivery of oral and general health care in patient-centered transdisciplinary collaboration for early detection and management of both hyperglycemia and oral diseases to improve quality of life.
Highlights
Dentistry was separated from general health care and became an independent profession [1], leaving little education and awareness regarding oral health and its links to general health among the other health professions [2,3,4,5,6,7,8,9,10].The most prevalent chronic diseases share the same “common risk factors” [11,12,13] (Figure 1) and often occur in the same patients, regardless of whether causal links and not merely associations exist
This research summarizes, in a nutshell, the current evidence for links between oral diseases and diabetes mellitus (DM) to support the need for transdisciplinary collaboration
Non-surgical periodontal treatment can lead to a decrease in glycated hemoglobin (HbA1c) level in type 2 DM (T2DM) after 3 months, which is of clinical significance as it is of the same order of magnitude as adding a second oral antidiabetic medication to metformin [156, 168, 169]
Summary
Dentistry was separated from general health care and became an independent profession [1], leaving little education and awareness regarding oral health and its links to general health among the other health professions [2,3,4,5,6,7,8,9,10]. Having loose teeth (due to periodontitis), sensitive teeth (due to deep caries lesions), few teeth left [104], or removable dentures will automatically cause problems with mastication, resulting in people not being able to eat crisp foods that need biting off or proper mastication. Oral and gut microbiomes are closely linked [132]; even a small number of periodontal bacteria predict change in glucose level in young healthy adults [133]. Non-surgical periodontal treatment can lead to a decrease in glycated hemoglobin (HbA1c) level in T2DM after 3 months, which is of clinical significance as it is of the same order of magnitude as adding a second oral antidiabetic medication to metformin [156, 168, 169]. Full-mouth extraction, the ultimate treatment of terminally periodontally diseased teeth, significantly lowers systemic inflammatory markers [190]
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