Oral Health of Diabetic Patients

Main Article Content

Da-Ming Liao
Chieh Chen


According to the American Dental Association (ADA), diabetes can increase the risk of oral diseases and other symptoms in the oral cavity. About one-fifth of tooth loss can be attributed to diabetes. Periodontal diseases include gingivitis and periodontitis. Gingivitis is the acute or chronic inflammation of the gums, which is usually caused by dental plaques. Five major impacts on oral health by diabetes include gum disease, dry mouth or change in taste, infection, slow healing and periodontal disease. In addition, beside affecting blood sugar; periodontal disease is also closely related to cardiovascular disease. Omega-3 polyunsaturated fatty acids (PUFA) are not only beneficial to cardiovascular and metabolism, but also can inhibit inflammation and diabetic patients.

Article Details

How to Cite
Liao, D.-M. and Chen, C. . (2023) “Oral Health of Diabetic Patients”, International Journal of Integrated Medical Research, 10(01), pp. 17–21. doi: 10.57181/ijoimr/vol10i01/103.
Research Article


• Lamster IB, Lalla E, Borgnakke WS, et al. The relationship between oral health and diabetes mellitus. J Am Dent Assoc 2008; 139:19-24S.

• Thorstensson H, Hugoson A. Periodontal disease experience in adult long-duration insulin-dependent diabetics. J Clin Periodontol 1993; 20:352-8.

• Latti BR, Kalburge JV, Birajdar SB, et al. Evaluation of relationship between dental caries, diabetes mellitus and oral microbiota in diabetics. Journal of oral and maxillofacial pathology: JOMFP 2018; 22(2): 282.

• Schulze A, Busse M. Gender differences in periodontal status and oral hygiene of non-diabetic and type 2 diabetic patients. The open dentistry journal 2016; 10: 287.

• Song TJ, Jeon J, Kim J. Cardiovascular risks of periodontitis and oral hygiene indicators in patients with diabetes mellitus. Diabetes & Metabolism 2021; 47(6): 101252.

• Al Amri, M. D., Kellesarian, S. V., Al‐Kheraif, A. A., Malmstrom, H., Javed, F, Romanos, G. E. Effect of oral hygiene maintenance on HbA1c levels and peri‐implant parameters around immediately‐loaded dental implants placed in type‐2 diabetic patients: 2 years follow‐up. Clinical Oral Implants Research 2016, 27(11), 1439-1443.

• Seppälä B, Seppälä M, Ainamo J. A longitudinal study on insulin-dependent diabetes mellitus and periodontal disease. J Clin Periodontol 1993; 20: 161-5.

• Chee B, Park B, Bartold PM. Periodontitis and type II diabetes: A two-way relationship. Int J Evid Based Healthc 2013; 11:317-29.

• O′Connell PA, Taba M, Nomizo A, et al. Effects of periodontal therapy on glycemic control and inflammatory markers. J Periodontol 2008; 79: 774-83.

• Shultis WA, Weil EJ, Looker HC, et al. Effect of periodontitis on overt nephropathy and end-stage renal disease in type 2 diabetes. Diabetes Care 2007; 30:306-11.

• Simpson TC, Weldon JC, Worthington HV, et al. Treatment of periodontal disease for glycaemic control in people with diabetes mellitus. Cochrane Database Syst Rev 2015;11:CD004714.

• DAROC Clinical Practice Guidelines for Diabetes Care-2018, Taiwan, Diabetes Association of the ROC 2018:160-3.

• Al Amassi, B. Y., Al Dakheel, R. S. Oral hygiene practice of adult diabetic patients and their awareness about oral health problems related to diabetes. Journal of Dentistry and Oral Hygiene 2017; 9(2): 8-14.

• Rees TD. The diabetic dental patient. Dent Clin North Am 1994; 38: 447-63.

• Yalda B, Offenbacher S, Collins JG. Diabetes as a modifier of periodontal disease expression. Periodontol 2000 1994; 6:37-49.

• D'Aiuto F, Gkranias N, Bhowruth D, et al. TASTE Group. Systemic effects of periodontitis treatment in patients with type 2 diabetes: a 12 month, single-centre, investigator-masked, randomised trial. Lancet Diabetes Endocrinol 2018; 6: 954-65.

• Preshaw PM, Taylor JJ. How has research into cytokine interactions and their role in driving immune responses impacted our understanding of periodontitis? J Clin Periodontol 2011; 38:60-84.

• Hanes PJ, Krishna R. Characteristics of inflammation common to both diabetes and periodontitis: Are predictive diagnosis and targeted preventive measures possible? EPMA J 2010; 1: 101-16.

• Sharma M, Jindal R, Siddiqui MA, et al. Diabetes and Periodontitis: A medical perspective. J Int Clin Dent Res Organ 2016; 8: 3-7.

• Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet 2005; 366:1809-20.

• Fermin A. Impact of periodontal infection on systemic health. In: Newman MG, Takei HH, Klokkevold PR, eds. Carranza’s Clinical Periodontology, 11th ed. Elsevier 2011.

• Raman RPC, Taiyeb-Ali TB, Chan SP, Chinna K, Vaithilingam RD. Effect of nonsurgical periodontal therapy verses oral hygiene instructions on type 2 diabetes subjects with chronic periodontitis: a randomised clinical trial. BMC Oral Health 2014; 14(1): 1-10.

• Taylor GW, Burt BA, Becker MP, et al. Severe periodontitis and risk for poor glycemic control in patients with non-insulin-dependent diabetes mellitus. J Periodontol 1996; 67: 1085-93.

• Machado V, Botelho J, Proença L, Alves R, Oliveira MJ, Amaro L, et al. Periodontal status, perceived stress, diabetes mellitus and oral hygiene care on quality of life: A structural equation modelling analysis. BMC Oral Health 2020; 20(1): 1-11.

• Bowyer V, Sutcliffe P, Ireland R, Lindenmeyer A, Gadsby R, Graveney M, et al. Oral health awareness in adult patients with diabetes: a questionnaire study. British dental journal 2011; 211(6): E12.

• Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 2003; 26: S5-20.

• Engebretson SP, Hyman LG, Michalowicz BS, et al. The effect of nonsurgical periodontal therapy on hemoglobin A1c levels in persons with type 2 diabetes and chronic periodontitis: A randomized clinical trial. JAMA 2013; 310: 2523-32.

• American Diabetes Association. Comprehensive medical evaluation and assessment of comorbidities: Standards of Medical Care in Diabetes—2020. Diabetes Care 2020; 43: S37-47.

• Luo H, Wu B, Kamer AR, et al. Oral Health, Diabetes, and Inflammation: Effects of Oral Hygiene Behavior. International Dental Journal 2022; 72(4): 484-90.

• Saengtipbovorn, S., Taneepanichskul, S. Effectiveness of lifestyle change plus dental care (LCDC) program on improving glycemic and periodontal status in the elderly with type 2 diabetes. BMC oral health 2014; 14(1): 1-10.

• Kelly M, Steele J, Nuttall N, et al. The condition of supporting structures. In: Walker A, Cooper I, editors. Adult Dental Health Survey: Oral Health in the United Kingdom 1998. London: The Stationery Office 2000;123-46.

• Cordero OJ, Varela-Calviño R. Oral hygiene might prevent cancer. Heliyon 2018; 4(10): e00879.

• Poudel, P., Griffiths, R., Wong, V. W., et al. Oral health knowledge, attitudes and care practices of people with diabetes: a systematic review. BMC public health 2018; 18(1): 1-12.

• Carra MC, Detzen L, Kitzmann J, et al. Promoting behavioural changes to improve oral hygiene in patients with periodontal diseases: A systematic review. Journal of clinical periodontology 2020; 47: 72-89.

• Delwel S, Binnekade TT, Perez RS, et al. Oral hygiene and oral health in older people with dementia: a comprehensive review with focus on oral soft tissues. Clinical oral investigations 2018; 22(1): 93-108.

• Miller LS, Manwell MA, Newbold D, et al. The relationship between reduction in periodontal inflammation and diabetes control: a report of 9 cases. J Periodontol 1992;63:843-8.

• Song TJ, Jeon J, Kim J. Cardiovascular risks of periodontitis and oral hygiene indicators in patients with diabetes mellitus. Diabetes & Metabolism 2021; 47(6): 101252.

• Rees TD. Periodontal management of the patient with diabetes mellitus. Periodontology 2000; 23: 63-72.

• Wang Y, Jiang Y, Chen Y, et al. Associations of oral hygiene with incident hypertension and type 2 diabetes mellitus: A population-based cohort study in Southwest China. The Journal of Clinical Hypertension 2022; 24(4): 483-92.

• Luo H, Wu B, Kamer AR, Adhikari S, Sloan F, Plassman BL, et al. Oral health, diabetes, and inflammation: Effects of oral hygiene behavior. International dental journal 2022; 72(4): 484-90.