Effect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence

Abstract

RJ. Effect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence. AbstractBackground: Periodontal disease and diabetes mellitus are common, chronic diseases worldwide. Epidemiologic and biologic evidence suggest periodontal disease may affect diabetes. Objective: To systematically review non-experimental, epidemiologic evidence for effects of periodontal disease on diabetes control, complications and incidence. Data sources: Electronic bibliographic databases, supplemented by hand searches of recent and future issues of relevant journals. Study eligibility criteria and participants: Longitudinal and cross-sectional epidemiologic, non-interventional studies that permit determination of directionality of observed effects were included. Study appraisal and synthesis methods: Four reviewers evaluated pair-wise each study. Review findings regarding study results and quality were summarized in tables by topic, using the PRISMA Statement for reporting and the NewcastleOttawa System for quality assessment, respectively. From 2246 citations identified and available abstracts screened, 114 full-text reports were assessed and 17 included in the review. Results: A small body of evidence supports significant, adverse effects of periodontal disease on glycaemic control, diabetes complications, and development of type 2 (and possibly gestational) diabetes. Limitations: There were only a limited number of eligible studies, several of which included small sample sizes. Exposure and outcome parameters varied, and the generalizability of their results was limited. Conclusions and implications of key findings: Current evidence suggests that periodontal disease adversely affects diabetes outcomes, and that further longitudinal studies are warranted.

Effects of C-reactive protein on the neutrophil respiratory burstin vitro

“…For example, systemic inflammation precedes type-2 diabetes, 64,65 and emerging evidence associates severe periodontitis with incident diabetes. 66 Periodontitis is also a recognised independent risk factor for diabetes complications (e.g. cardio-renal complications) 66 in a dose-dependent manner, and further associates with elevated HbA1c and low-density lipoprotein cholesterol concentrations.…”

Defining the gut microbiota in individuals with periodontal diseases: an exploratory study

“…Among those, periodontal diseases are complex polymicrobial inflammatory diseases associated with dysbiosis of the dental biofilm that induces a long-lasting chronic inflammation of the periodontal supporting tissues, leading to alveolar bone destruction, and eventual tooth loss [6]. Over the years, strong evidence has accumulated to indicate that the pathogenic microbiota and the chronic inflammation established in periodontitis contribute to the onset and/or progression of several systemic inflammatory diseases such as cardiovascular diseases [7,8], diabetes [9], obesity [10], metabolic syndrome [11], respiratory disease [12], cancer [13], chronic kidney disease (CKD) [14] and rheumatoid arthritis (RA) [15]. Most research on the periodontitis-systemic disease relationship, however, has not determined causality, and the link between these diseases are bi-directional associations [16].…”

A Life Course Perspective on Health Trajectories and Transitions

“…Further, there is evidence for direct links between oral health and general health. Systematic reviews concluded that poor oral hygiene and periodontal disease are risk factors for pneumonia, and possibly also for chronic obstructive pulmonary disease (Azarpazhooh and Leake 2006;Sjögren et al 2008), and that periodontal disease adversely affects diabetes outcomes (Borgnakke et al 2013). …”