Obesity, Diabetes, and Dental Health: Relationship and Management



It is widely recognized that overweight or obesity is associated with a number of risk factors, including type 2 diabetes, ischemic heart disease, hypertensive disorders, and cancer. The complications of diabetes have been well documented and can include macrovascular or microvascular involvement with deterioration of this condition.

Over and above an accepted oral-systemic link, less is known about other complications, such as the association between dental disease and systemic inflammation, which has been linked with other inflammatory conditions, including Alzheimer’s disease. The dental practitioner should be regarded as a key member of the diabetes multidisciplinary team and is ideally placed to identify patients with poor glycemic control. By directly treating any signs of periodontal disease, together with referral to a general practitioner for diabetes diagnosis, the increasing incidence of obesity and diabetes that is impacting on our health-care system may be reduced.


Obesity Type 2 diabetes Diabetes complications Dental decay Dental erosion Periodontal disease 


  1. 1.
    Löe H. Periodontal disease. The sixth complication of diabetes mellitus. Diabetes Care. 1993;16(1):329–34.PubMedGoogle Scholar
  2. 2.
    Mealey BL. Periodontal disease and diabetes: a two-way street. J Am Dent Assoc. 2006;137:26S–31.PubMedGoogle Scholar
  3. 3.
    Mealey BL, Ocampo GL. Diabetes mellitus and periodontal disease. Periodontol 2000. 2007;44:127–53.PubMedCrossRefGoogle Scholar
  4. 4.
    Lakschevitz F, Aboodi G, Tenenbaum H, Glogauer M. Diabetes and periodontal diabetes and periodontal diseases: interplay and links. Curr Diabetes Rev. 2011;7(6):433–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Nelson RG, Shlossman M, Budding LM, Pettitt DJ, Saad MF, Genco RJ, et al. Periodontal disease and NIDDM in Pima Indians. Diabetes Care. 1990;13:836–40.PubMedCrossRefGoogle Scholar
  6. 6.
    Firatli E. The relationship between clinical periodontal status and insulin-dependent diabetes mellitus. Results after 5 years. J Periodontol. 1997;68:136–40.PubMedCrossRefGoogle Scholar
  7. 7.
    Saremi A, Nelson RG, Tulloch-Reid M, Hanson RL, Sievers ML, Taylor GW, et al. Periodontal disease and mortality in type 2 diabetes. Diabetes Care. 2005;28:27–32.PubMedCrossRefGoogle Scholar
  8. 8.
    Touger-Decker R, van Loveren C. Sugars and dental caries. Am J Clin Nutr. 2003;78(Suppl):881S–92.PubMedGoogle Scholar
  9. 9.
    Graves D. Cytokines that promote periodontal tissue destruction. J Periodontol. 2008;79(8 Suppl):1585S–91.CrossRefGoogle Scholar
  10. 10.
    Liu YC, Lerner UH, Teng YT. Cytokine responses against periodontal infection: protective and destructive roles. Periodontol 2000. 2000;2010(52):163–206.Google Scholar
  11. 11.
    Tunes SR, Foss-Freitas MC, Nogueira-Filho Gda R. Impact of periodontitis on the diabetes-related inflammatory status. J Can Dent Assoc. 2010;76:a35.Google Scholar
  12. 12.
    Bays H, Mandarino L, DeFronzo R. Role of the adipocyte, free fatty acids, and ectopic fat in pathogenesis of type 2 diabetes mellitus: peroxisomal proliferator-activated receptor agonists provide a rational therapeutic approach. J Clin Endocrinol Metab. 2004;89:463–78.PubMedCrossRefGoogle Scholar
  13. 13.
    UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352(9131):837–53.CrossRefGoogle Scholar
  14. 14.
    UK Prospective Diabetes Study 6. Complications in newly diagnosed type 2 diabetic patients and their association with different clinical and biochemical risk factors. Diabetes Res. 1990;13(1):1–11.Google Scholar
  15. 15.
    Mealey BL, Rose LF. Diabetes mellitus and inflammatory periodontal diseases. Curr Opin Endocrinol Diabetes Obes. 2008;15(2):135–41.PubMedCrossRefGoogle Scholar
  16. 16.
    Nagasawa T, Noda M, Katagiri S, Takaichi M, Takahashi Y, Wara-Aswapati N, et al. Relationship between periodontitis and diabetes-importance of a clinical study to prove the vicious cycle. Intern Med. 2010;49:881–5.PubMedCrossRefGoogle Scholar
  17. 17.
    Tsai C, Hayes C, Taylor GW. Glycemic control of type 2 diabetes and severe periodontal disease in the US adult population. Community Dent Oral Epidemiol. 2002;30:182–92.PubMedCrossRefGoogle Scholar
  18. 18.
    Grossi SG, Skrepcinski FB, DeCaro T, Zambon JJ, Cummins D, Genco RJ, et al. Response to periodontal therapy in diabetics and smokers. J Periodontol. 1996;67(10 Suppl):1094–102.PubMedCrossRefGoogle Scholar
  19. 19.
    Grossi SG, Skrepcinski FB, DeCaro T, Robertson DC, Ho AW, Dunford RG, et al. Treatment of periodontal disease in diabetics reduces glycated hemoglobin. J Periodontol. 1997;68:713–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Stewart JE, Wager KA, Friedlander AH, Zadeh HH. The effect of periodontal treatment on glycemic control in patients with type 2 diabetes mellitus. J Clin Periodontol. 2001;28:306–10.PubMedCrossRefGoogle Scholar
  21. 21.
    Gerdin EW, Angbratt M, Aronsson K, Eriksson E, Johansson I. Dental caries and body mass index by socio-economic status in Swedish children. Community Dent Oral Epidemiol. 2008;36:459–65.PubMedCrossRefGoogle Scholar
  22. 22.
    Marshall TA, Eichenberger-Gilmore JM, Broffitt BA, Warren JJ, Levy SM. Dental caries and childhood obesity: roles of diet and socioeconomic status. Community Dent Oral Epidemiol. 2007;35:449–58.PubMedCrossRefGoogle Scholar
  23. 23.
    de Silva-Sanigorski AM, Waters E, Calache H, Smith M, Gold L, Gussy M, et al. Splash!: a prospective birth cohort study of the impact of environmental, social and family-level influences on child oral health and obesity related risk factors and outcomes. BMC Public Health. 2012;11:505.CrossRefGoogle Scholar
  24. 24.
    Malik VS, Hu FB. Sweeteners and risk of obesity and type 2 diabetes: the role of sugar-sweetened beverages. Curr Diab Rep. 2012. [Epub ahead of print].Google Scholar
  25. 25.
    Marshall TA, Levy SM, Broffitt B, Warren JJ, Eichenberger-Gilmore JM, Burns TL, et al. Dental caries and beverage consumption in young children. Pediatrics. 2003;112:e184–91.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.Watton Place ClinicWatton at StoneUK

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