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Type 1 Diabetes Mellitus and Periodontal Health

  • Systemic Diseases (N Buduneli, Section Editor)
  • Published:
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Abstract

Purpose of Review

This review examines the current literature on the possible two-way interaction between type 1 diabetes mellitus and periodontal health.

Recent Findings

The literature on type 1 diabetes and periodontal disease is rather scarce and mainly involves clinical investigations in children and adolescents. However, recent studies on adult populations with type 1 diabetes suggest that both chronic inflammatory diseases affect each other negatively.

Summary

Type 1 diabetes is likely to increase the risk of onset and progression of periodontal disease. Further large-scale and controlled studies on adult population are warranted to better clarify the nature as well as possible mechanisms for the relationship between type 1 diabetes mellitus and periodontal disease.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Katsarou A, Gudbjörnsdottir S, Rawshani A, Dabelea D, Bonifacio E, Andersen BJ, et al. Type 1 diabetes mellitus. Nat Rev Dis Primers. 2017;3:17016.

    Article  PubMed  Google Scholar 

  2. Boldison J, Wong FS. Immune and pancreatic beta cell interactions in type 1 diabetes. Trends Endocrinol Metab. 2016;27(12):856–67.

    Article  CAS  PubMed  Google Scholar 

  3. Redondo MJ, Fain PR, Eisenbarth GS. Genetics of type 1A diabetes. Recent Prog Horm Res. 2001;56:69–89.

    Article  CAS  PubMed  Google Scholar 

  4. Oikarinen S, Tauriainen S, Hober D, et al. Virus antibody survey in different European populations indicates risk association between coxsackievirus B1 and tyoe 1 diabetes. Diabetes. 2014;63(2):655–62.

    Article  CAS  PubMed  Google Scholar 

  5. Hober D, Sane F. Enteroviral pathogenesis of type 1 diabetes. Discovery Med. 2010;10(51):151–60.

    Google Scholar 

  6. Virtanen SM, Knip M. Nutritional risk predictors of b cell autoimmunity and type 1 diabetes at a young age. Am J Clin Nutri. 2003;78(6):1053–67.

    Article  CAS  Google Scholar 

  7. D’Angeli MA, Merzon E, Valbuena LF, Tirschwell D, Paris CA, Mueller BA. Environmental factors associated with childhood-onset type 1 diabetes mellitus: an exploration of the hygiene and overload hypotheses. Arch Ped Adolesc Med. 2010;164(8):732–8.

    Article  Google Scholar 

  8. Novotna M, Podzimek S, Broukal Z, Lencova E, Duskova J. Periodontal diseases and dental caries in children with type 1 diabetes mellitus. Med Inflamm 2015;379626.

  9. Cinek O. Epidemiology of childhood type 1 diabetes mellitus: lessons from Central and Eastern European data. Hormone Res Paed. 2011;76(1):52–6.

    Article  CAS  Google Scholar 

  10. •• Genco RJ, Borgnakke WS. Diabetes as a potential risk for periodontitis: association studies. Periodontol. 2000;2020(83):40–5. This review paper provides comprehensive information on diabetes and oral health interactions.

    Google Scholar 

  11. Löe H. Periodontal disease the sixth complication of diabetes mellitus. Diabetes Care. 1993;16:324–34.

    Article  Google Scholar 

  12. •• Steigmann L, Miller R, Trapani VR, Giannobile WV, et al. Type 1 diabetes and oral health: findings from the Epidemiology of Diabetes Interventions and Complications (EDIC) study. J Diab Compl. 2022;36:108120. This paper provides recent epidemiological data on diabetes and oral health.

    Article  Google Scholar 

  13. Duda-Sobczak A, Zozulinska-Ziolkiewicz D, Wyganowska-Swiatkowska M. Type 1 diabetes and periodontal health. Clin Ther. 2018;40(6):823–7.

    Article  PubMed  Google Scholar 

  14. Jivanescu A, Bondor CI, Pop-Busui R, et al. Association between oral health status and diabetic neuropathy in a large Romanian cohort of patients with diabetes. Diabetes Care. 2018;41:e139-140.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Eid S, Sas KM, Abcouwer SF, et al. New insights into the mechanisms of diabetic complications: role of lipids and lipid metabolism. Diabetologia. 2019;62:1539–49.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Barrett EJ, Liu Z, Khamaisi M, et al. Diabetic microvascular disease: an endocrine society scientific statement. J Clin Endocrinol Metab. 2017;102:4343–410.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Lang NP, Adler R, Joss A, Nyman S. Absence of bleeding on probing An indicator of periodontal stability. J Clin Periodontol. 1990;17:714–21.

    Article  CAS  PubMed  Google Scholar 

  18. Albert DA, Ward A, Allweis P, Graves DT, et al. Diabetes and oral disease: implications for health professionals. Ann New York Acad Sci. 2012;1255(1):1–15.

    Article  Google Scholar 

  19. •• Sanz M, Ceriello A, Buysschaert M, Chapple I, et al. Scientific evidence on the links between periodontal diseases and diabetes: consensus report and guidelines of the joint workshop on periodontal diseases and diabetes by the International Diabetes Federation and the European Federation of Periodontology. J Clin Periodontol. 2018;45(2):138–49. This consensus report provides current guidelines about diabetes and oral health for both periodontists and endocrinologists.

    Article  CAS  PubMed  Google Scholar 

  20. •• Graziani F, Gennai S, Solini A, Petrini M. A systematic review and meta-analysis of epidemiologic observational evidence on the effect of periodontitis on diabetes An update of the EFP-AAP review. J Clin Periodontol. 2018;45(2):167–87. ()

    Article  PubMed  Google Scholar 

  21. Polak D, Sanui T, Nishimura F, Shapira L. Diabetes as a risk factor for periodontal disease-plausible mechanisms. Periodontol. 2020;83(1):46–58.

    Article  Google Scholar 

  22. Lalla E, Papapanou PN. Diabetes mellitus and periodontitis: a tale of two common interrelated diseases. Nat Rev Endocrinol. 2011;7:738–48.

    Article  CAS  PubMed  Google Scholar 

  23. Salvi GE, Franco LM, Braun TM, et al. Pro-inflammatory biomarkers during experimental gingivitis in patients with type 1 diabetes mellitus: a proof-of-concept study. J Clin Periodontol. 2010;37(1):9–16.

    Article  CAS  PubMed  Google Scholar 

  24. Salvi GE, Kandylaki M, Troendle A, Persson GR, lang NP. Experimental gingivitis in type 1 diabetics: a controlled clinical and microbiological study. J Clin Periodontol. 2005;32(3):310–6.

    Article  PubMed  Google Scholar 

  25. Siudikiene J, Maciulskiene V, Dobrovolskiene R, Nedzelskiene I. Oral hygiene in children with type 1 diabetes mellitus. Stomatologija. 2005;7(1):24–7.

    PubMed  Google Scholar 

  26. Lalla E, Cheng B, Lal S, et al. Periodontal changes in children and adolescents with diabetes: a case-control study. Diabetes Care. 2006;29(2):295–9.

    Article  PubMed  Google Scholar 

  27. İsmail AF, McGrath CP, Yiu CK. Oral health of children with type 1 diabetes mellitus: a systematic review. Diabetes Res Clin Pract. 2015;108(3):369–81.

    Article  PubMed  Google Scholar 

  28. Jensen E, Allen G, Bednarz J, Couper J, Pena A. Periodontal risk markers in children and adolescents with type 1 diabetes: a systematic review and meta-analysis. Diabetes Metab Res Rev. 2021;37(1):e3368.

    Article  PubMed  Google Scholar 

  29. •• Dicembrini I, Serni L, Monami M, Caliri M, Barbato L, Cairo F, et al. Type 1 diabetes and periodontitis: prevalence and periodontal destruction - a systematic review. Acta Diabetol. 2020;57(12):1405–12. This systematic review provides current information on the possible interactions between periodontitis and type 1 diabetes.

    Article  PubMed  Google Scholar 

  30. Rapone B, Corsalini M, Converti I, et al. Does periodontal inflammation affect type 1 diabetes in childhood and adolescence? A meta-analysis. Front Endocrinol. 2020;11:278.

    Article  Google Scholar 

  31. Roy M, Gastaldi G, Courvoisier DS, Mombelli A, Giannopoulou C. Periodontal health in a cohort of subjects with type 1 diabetes mellitus. Clin Exp Dent Res. 2019;5:243–9.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Iughetti L, Marino R, Bertolani MF, Bernasconi S. Oral health in children and adolescents with IDDM - a review. J Ped Endocrinol Met. 1999;12((5 suppl 2)):603–10.

    Google Scholar 

  33. Ryan ME, Ramamurthy NS, Sorsa T, Golub LM. MMP-mediated events in diabetes. Ann New York Acad Sci. 1999;878:311–34.

    Article  CAS  Google Scholar 

  34. Ryan ME, Carnu O, Kamer A. The influence of diabetes on the periodontal tissues. JADA. 2003;134:34S-40S.

    PubMed  Google Scholar 

  35. Ryan ME, Usman A, Ramamurthy NS, Golub LM, Greenwald RA. Excessive matrix metalloproteinase activity in diabetes: inhibitions by tetracycline analogues with zinc reactivity. Curr Med Chem. 2001;8(3):305–16.

    Article  CAS  PubMed  Google Scholar 

  36. Grover HS, Luthra S. Molecular mechanisms involved in the bidirectional relationship between diabetes mellitus and periodontal disease. J Indian Soc Periodontol. 2013;17(3):292–301.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Merchant AT, Nahhas GJ, Wadwa RP, et al. Periodontal microorganisms and cardiovascular risk markers in youth with type 1 diabetes and without diabetes. J Periodontol. 2016;87(4):376–84.

    Article  CAS  PubMed  Google Scholar 

  38. •• Cairo F, Dicembrini I, Serni L, et al. Periodontitis predicts HbA1c levels and glucose variability in type 1 diabetic patients: the PARODIA Florence Project study. Clin Oral Invest. 2022;26:3585–91. This study investigates possible interaction between periodontitis and type 1 diabetes in terms of HbA1c levels.

    Article  Google Scholar 

  39. Yılmaz D, Topçu AO, Akçay EU, Altındiş M, Gursoy UK. Salivary human beta-defensins and cathelicidin levels in relation to periodontitis and type 2 diabetes mellitus. Acta Odontol Scand. 2020;78:327–31.

    Article  PubMed  Google Scholar 

  40. Pereira AG, Costa LCM, Soldati KR, Guimaraes de Abreu MHN, Costa FO, Zandim-Barcelos DL, Cota LOM. Gingival crevicular fluid levels of human beta-defensin 2 and 3 in healthy and diseased sites of individuals with and without periodontitis. J Int Acd Periodontol. 2020;22:90–9.

    Google Scholar 

  41. Suarez-Carmona M, Hubert P, Delvenne P, Herfs M. Defensins: simple antimicrobial peptides or broad-spectrum molecules? Growth Factor Rev. 2015;26:361–70.

    Article  CAS  Google Scholar 

  42. Yılmaz D, Yılmaz N, Polat R, et al. Salivary levels of hBDs in children and adolescents with type 1 diabetes mellitus and gingivitis. Clin Oral Invest 2022; in press.

  43. Widen C, Holmer H, Sattlin S, Renvert S, Lernmark A, Persson GR. Periodontal conditions, retinopathy, and serum markers in individuals with type 1 diabetes. J Periodontol. 2020;91:1436–43.

    Article  CAS  PubMed  Google Scholar 

  44. Zizzi A, Tirabassi G, Aspriello SD, Piemontese M, Rubini C, Lucarini G. Gingival advanced glycation end-products in diabetes mellitus-associated chronic periodontitis: an immunohistochemical study. J Periodont Res. 2013;48(3):293–301.

    Article  CAS  Google Scholar 

  45. Sereti M, roy M, Zekeridou A, Gastaldi G, Giannopoulou C. Gingival crevicular fluid biomarkers in type 1 diabetes mellitus: a case-control study. Clin Exp Dent Res. 2021;7:170–8.

    Article  PubMed  Google Scholar 

  46. Raedel M, Noack B, Priess H-W, Bohm S, Walter MH. Massive data analyses show negative impact of type 1 and 2 diabetes on the outcome of periodontal treatment. Clin Oral Invest. 2021;25:2037–43.

    Article  Google Scholar 

  47. King GL. The role of inflammatory cytokines in diabetes and its complications. J Periodontol. 2008;79(8):1527–34.

    Article  CAS  PubMed  Google Scholar 

  48. Shoelson SE, Lee J, Goldfine AB. Inflammation and insulin resistance. J Clin Invest. 2006;116:1793–801.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Borges I Jr, Moreira EA, Filho DW, de Oliveira TB, da Silva MB, Fröde TS. Proinflammatory and oxidative stress markers in patients with periodontal disease. Mediators Inflamm. 2007;2007:45794.

    Article  PubMed  Google Scholar 

  50. Taylor GW. The effects of periodontal treatment on diabetes. JADA. 2003;134:41S-48S.

    PubMed  Google Scholar 

  51. Kornman KS. Mapping the pathogenesis of periodontitis: a new look. J Periodontol. 2008;79(8 Suppl.):1560–8.

    Article  CAS  PubMed  Google Scholar 

  52. Alonso N, Martinez-Arconada MJ, Granada ML, et al. Regulatory T cells in type 1 diabetic patients with autoimmune chronic atrophic gastritis. Endocrine. 2009;35(3):420–8.

    Article  CAS  PubMed  Google Scholar 

  53. Aldridge JP, Lester V, Watts TLP, Collins A, Viberti G, Wilson RF. Single-blind studies of the effects of improved periodontal health on metabolic control in type 1 diabetes mellitus. J Clin Periodontol. 1995;22:271–5.

    Article  CAS  PubMed  Google Scholar 

  54. Westfelt E, Rylander H, Blohme G, Jonasson P, Lindhe J. The effect of periodontal therapy in diabetics Results after 5 years. J Clin Periodontol. 1996;23:92–100.

    Article  CAS  PubMed  Google Scholar 

  55. Peruzzo Lopes CC, do Monte Ribeiro Busata P, Michelin Manica MF, et al. Effect of basic periodontal treatment on glycemic control and inflammation in patients with diabetes mellitus type 1 and type 2: controlled clinical trial. J Public Health (2017) 25(4):443-449

  56. Skaleric U, Schara R, Medvescek M, Hanlon A, Doherty F, Lessem J. Periodontal treatment by Arestin and its effects on glycemic control in type 1 diabetes patients. J Int Acad Periodontol. 2004;6(4 Suppl):160–5.

    PubMed  Google Scholar 

  57. Llambes F, Sivestre FJ, Hernandez-Mijares A, Guiha R, caffesse R. The effect of periodontal treatment on metabolic control of type 1 diabetes mellitus. Clin Oral Investig. 2008;12(4):337–43.

    Article  PubMed  Google Scholar 

  58. Tervonen T, Lamminsalo S, Hiltunen L, Raunio T, Knuuttila M. Resolution of periodontal inflammation does not guarantee improved glycemic control in type 1 diabetic subjects. J Clin Periodontol. 2009;36(1):51–7.

    Article  PubMed  Google Scholar 

  59. Buzinin SM, Alabsi AM, Tan AT, Vincent-Chong VK, Swaminathan D. Effects of nonsurgical periodontal therapy on clinical response, microbiological profile, and glycemic control in Malaysian subjects with type 1 diabetes. The Scientific World Journal 2014;Jan 1:2014.

  60. Smith GT, Greenbaum CJ, Johnson BD, Persson GR. Short-term responses to periodontal therapy in insulin-dependent diabetic patients. J Periodontol. 1996;67:794–802.

    Article  CAS  PubMed  Google Scholar 

  61. Christgau M, Palitzsch KD, Schmalz G, Kreiner U, Frenzel S. Healing response to non-surgical periodontal therapy in patients with diabetes mellitus: clinical, microbiological, and immunologic results. J Clin Periodontol. 1998;25:112–24.

    Article  CAS  PubMed  Google Scholar 

  62. Engebretson S, Kocher T. Evidence that periodontal treatment improves diabetes outcomes: a systematic review and meta-analysis. J Periodontol. 2013;84(suppl 4):S153–69.

    PubMed  PubMed Central  Google Scholar 

  63. Janket SJ, Wightman A, Baird AE, Van Dyke TE, Jones JA. Does periodontal treatment improve glycemic control in diabetic patients? A meta-analysis of intervention studies. J Dent Res. 2005;84(12):1154–9.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Periodontology, Faculty of Dentistry, Ege University, 35100, Bornova, İzmir, Turkey

    Nurcan Buduneli

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  1. Nurcan Buduneli
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This article has been reviewed by Prof. Olivier Huck, as Dr. Nurcan Buduneli is a Section Editor for the topical collection Systemic Diseases.

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Buduneli, N. Type 1 Diabetes Mellitus and Periodontal Health. Curr Oral Health Rep 9, 119–125 (2022). https://doi.org/10.1007/s40496-022-00322-z

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