Poor glycemic control results in fewer teeth, research finds

By Editor
17th November 2021

The largest ever research study into tooth loss and glycemic control has found that people aged over 30 with high HbA1c levels and elevated fasting blood glucose levels (FPG) are more likely to have fewer natural teeth remaining.

People at risk are being advised to take steps to better manage their glycemic levels and improve their oral care, for example through smoking cessation.

Lead researchers, Professor Hiroshi Maegawa and Associate Professor Katsutaro Morino examined the oral health of 233,567 individuals aged between 20 and 70 years old to assess the relationship between glycemic control and tooth retention for different age groups.

They found that participants with impaired fasting glucose were already at risk of having fewer teeth between 40 and 90 years old compared to those with normal FPG.

In addition, they discovered that the risk of tooth loss is further increased due to a combination of high blood glucose levels and smoking.

Entitled ‘Glycemic control and number of natural teeth: analysis of cross-sectional Japanese employment-based dental insurance claims and medical check-up data study’, the research emphasises the importance of glycemic control and oral care to protect against tooth loss.

According to the scientists, this means that anyone diagnosed with diabetes or prediabetes should aim to improve their glycemic control and undergo a dental check-up, while anyone with high blood sugar levels should look at preventative oral care to protect against future tooth loss.

Participants were assigned to five groups based on their HbA1c and three groups according to their FPG, with the number of natural teeth then compared.

Additionally, the researchers examined the dental records, HbA1c levels and smoking data of each person that took part.

Participants were categorised according to two glycemic control parameters: HbA1c < 5.5%, 5.5–6.4%, 6.5–7.4%,7.5–8.4%, or ≥ 8.5% [19]; and FPG < 110 mg, 110–125 mg/dl, or ≥ 126 mg/dl in each 10-year age group, while the FPG categories were set with reference to the World Health Organization’s criteria for impaired fasting glucose.

No large studies had previously examined whether there is a continuous relationship of poorer glycemic control and fewer natural teeth at the age when this relationship appears.

These findings prove that glycemic control is strongly associated with the number of natural teeth in a real-world setting. 

Although cross-sectional design has a limit on establishing a causal relationship, the data strongly supports the previous longitudinal and interventional study and suggests the importance of glycemic control, stopping smoking and appropriate oral care to protect anyone with impaired fasting glucose or diabetes against tooth loss from a young age.

The researchers collaborated with international oral healthcare company, Sunstar to gather this research.

The entire research study can now be accessed in the journal ‘Diabetology International’.

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