Better dental health found to improve blood glucose control in people living with type 2 diabetes
People who clean their teeth using floss or interdental brushes at least three times a week report more time spent in the healthy blood glucose range.
Adults with type 2 diabetes who clean between their teeth three or more times a week (with floss or interdental brushes) have more stable 24-hour blood glucose levels, according to a new study.
Researchers found that adults with 20 or more natural teeth also showed lower glucose levels throughout the day.
The study was carried out by researchers in Japan at the Sunstar Group, Clinic Masae Minami, and the Minami Diabetes Clinical Research Center, with their findings recently published in the American Diabetes Association’s Journal Diabetes Spectrum.
The study explored the underexposed relationship between daily oral care routines and glucose management. The study also looked at the role inflammation could potentially have as an underlying factor in this association.
Researchers reported that adults with type 2 diabetes who practiced interdental cleaning at least three times per week had extended periods within the healthy target glucose range and lower overall glucose variability.
This showed the significance of daily oral care routines, such as interdental cleaning.
The findings demonstrated the potential benefits of integrating medical and dental care for adults living with type 2 diabetes.
The recent study followed on from previous findings of the close interconnection between diabetes and periodontal disease.
Researchers noted that treating periodontal disease is known to potentially lower HbA1c levels, an established glycaemic indicator.
However, while previous studies focused on clinical treatment, the potential impact of oral care practices on daily glucose management in type 2 diabetes is a previously underexplored area.
The research study monitored 104 adults living with type 2 diabetes, who were using arm-mounted sensors for continuous glucose monitoring (CGM) for 14 days, alongside blood tests and surveys on their oral health routines.
Researchers collected information on their dental visits, toothbrushing, interdental cleaning, and how many natural teeth they had.
Researchers also analysed Time in Range (TIR) – the time blood glucose stays in the target range and glucose management indicator (GMI), an estimate of overall glucose control based on CGM figures.
Researchers found that people who used interdental methods to clean their teeth more than three times a week spent more time in the higher TMI range and had lower GMI (reflecting lower 24-hour average glucose). They also had lower fasting glucose and stable day-to-day‑ glucose profiles.
People with more than 20 natural teeth showed more favourable 24-hour glucose profiles than those with fewer teeth.
More frequent dental visits and twice daily toothbrushing were also linked with healthier metabolic and inflammation markers.
The report findings said: “While these links remained significant even after accounting for age and sex, importantly the benefits of interdental cleaning were not fully explained by inflammation markers, suggesting other pathways may be involved.
“Although a cross-sectional study, the research demonstrates that daily oral care routines, especially interdental cleaning and tooth retention are associated with steadier blood glucose and play a significant role in diabetes management.
“Integrating dental care and oral health checks into diabetes care could also provide a practical low-cost step to support glucose management, while improving patients’ understanding of this two-way connection between oral hygiene and diabetes, and increasing dental visits.”
Dr Yasutaka Maeda, Diabetes Specialist at Clinic Masae Minami and Director of Minami Diabetes Clinical Research Center, said: “This study demonstrated a strong relationship between daily oral hygiene practices and glucose management. Dietitian-led oral hygiene assessments conducted in this study prompted patients to better understand periodontal disease, leading to more dental visits.
“Nurses are also now utilising Oral Frailty Check Sheets to address aging-related issues in diabetes care and establishing a smooth medical-dental collaboration system within our clinic. More healthcare facilities are expected to implement similar collaborations by utilising these research findings which clearly communicate the importance of oral care for people with diabetes.”
Read the report in Diabetes Spectrum
Read the DRWF diabetes information leaflet Looking after gum health with diabetes
Read more about type 2 diabetes
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