Evidence summary: The relationship between oral diseases and diabetes

Key Points Current evidence suggests a number of associations between oral diseases (periodontitis, tooth loss, oral cancer) and diabetes mellitus (diabetes). Whilst diabetic patients are at increased risk of post-surgical complications generally, there is little evidence that they are at increased risk following surgery in the oral cavity. There is evidence that oral healthcare/management of oral disease, most notably periodontal care, has a short term beneficial influence on diabetes outcomes but there is no evidence that this is sustained over the long-term and/or reduces the development of the complications of diabetes. Regular periodontal/oral care may benefit patients with periodontitis and diabetes. A diagnosis of diabetes should be considered and excluded in those who have severe periodontitis and vice versa. Introduction This paper is the third of four rapid reviews undertaken to explore the relationships between oral health and general medical conditions in order to support teams within Public Health England, health practitioners and policymakers. Aims This review aimed to explore the nature of the association between poor oral health and diabetes when found in the same individuals or populations, having reviewed the most contemporary evidence in the field. Methods The reviews were undertaken by four groups each comprising consultant clinicians from medicine and dentistry, trainees, public health and academics. The methodology involved a streamlined rapid review process and synthesis of the findings. Results The results identified a number of systematic reviews of low to high quality suggesting that diabetes is associated with periodontal disease, tooth loss, and oral cancer in particular, and that the management of oral diseases, most notably periodontal care, has a short-term beneficial influence on metabolic outcomes related to diabetes; however, there is no evidence that this is sustained over the long-term and reduces the prevalence of the long-term complications. Conclusion Current evidence, of mixed quality, suggests a number of associations between oral diseases and diabetes mellitus (diabetes). Further high quality research is required in this field.