The importance of early identification of prediabetic indicators has become increasingly more recognized by the clinical community. Hyperglycemia, as measured with blood glucose monitoring or by a more accurate depiction of hemoglobin A1c (HbA1c) values over time, has traditionally been the measure used to predict and diagnosis diabetes. New research highlights findings presented March 2018 at the 100th annual meeting of the Endocrine Society in Chicago, Illinois highlighted an alternative indicator, dental health, as a precursor/predictor of diabetes.  

Compromised dental health not only is associated with an increased risk of diabetes, according to lead author, Raynald Samoa, MD, an assistant professor in the Department of Diabetes, Endocrinology & Metabolism at City of Hope National Medical Center in Duarte, California, but may also offer an opportunity to screen for diabetes. "Our findings suggest that dental exams may provide a way to identify someone at risk for developing diabetes. We found a progressive positive relationship between worsening glucose tolerance and the number of missing teeth. Although a causal relationship cannot be inferred from this cross-sectional study, it demonstrates that poor dental outcome can be observed before the onset of overt diabetes," Samoa said.

Samoa et al evaluated 9,670 adult individuals who were examined by dentists during the National Health and Nutrition Examination Survey conducted from 2009 to 2014. The team reviewed diabetes diagnosis, HbA1c, and the type of medication intervention and other factors along with the number of missing teeth, presence of dental disease, and demographic characteristics including, but not limited to, age, sex and ethnicity. The authors reported that an increased number of missing teeth was associated with progressive decreases of glucose tolerance (45.57% in the group with normal glucose tolerance [NGT] compared to 67.61% in the group with abnormal glucose tolerance [AGT] and to 82.87% in the group with a diagnosis of diabetes mellitus). In addition to the increased number of individuals with missing teeth, the average number of missing teeth per individual within the abnormal glucose tolerance groups was also significantly increased: (2.26 in the NGT group compared to 4.41 in the AGT group and 6.80 in those with diabetes mellitus)

Using dental exams as a measure of one’s risk for diabetes may facilitate an opportunity to increase earlier interventions since these exams may provide earlier indicators before blood tests can confirm a diagnosis. “The health of your teeth maybe a sign of your risk for diabetes,” said Samoa.

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