Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

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.

This is a preview of subscription content

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Figure 1


  1. 1

    National Health Service. Five year forward view 2014 11/11/2014. Available at: (accessed May 2017).

  2. 2

    World Health Organization. International Classification of Diseases ICD-10. Geneva: WHO, 2017. Available at: (accessed May 2017).

  3. 3

    Bullon P, Newman H N, Battino M . Obesity, diabetes mellitus, atherosclerosis and chronic periodontitis: a shared pathology via oxidative stress and mitochondrial dysfunction? Periodontol 2000 2014; 64: 139–153.

    Article  Google Scholar 

  4. 4

    King P, Peacock I, Donnelly R . The UK prospective diabetes study (UKPDS): clinical and therapeutic implications for type 2 diabetes. Br J Clin Pharmacol 1999; 48: 643–648.

    Article  Google Scholar 

  5. 5

    Eckel R H, Kahn S E, Ferrannini E et al. Obesity and type 2 diabetes: what can be unified and what needs to be individualized? Diabetes Care 2011; 34: 1424–1430.

    Article  Google Scholar 

  6. 6

    Fejerskov O, Kidd E . Dental caries: the disease and its clinical management. John Wiley & Sons, 2009.

    Google Scholar 

  7. 7

    Eke P I, Page R C, Wei L, Thornton-Evans G, Genco R J . Update of the case definitions for population-based surveillance of periodontitis. J Periodontol 2012; 83: 1449–1454.

    Article  Google Scholar 

  8. 8

    Steele J, O'Sullivan I . Adult Dental Health Survey 2011 21/05/2011. Available at: (accessed May 2017).

  9. 9

    Khangura S, Konnyu K, Cushman R, Grimshaw J, Moher D . Evidence summaries: the evolution of a rapid review approach. Syst Rev 2012; 1: 10 10.1186/2046-4053-1-10.

    Article  PubMed  PubMed Central  Google Scholar 

  10. 10

    Oates T W, Huynh-Ba G, Vargas A, Alexander P, Feine J . A critical review of diabetes, glycaemic control, and dental implant therapy. Clin Oral Implants Res 2013; 24: 117–27.

    Article  Google Scholar 

  11. 11

    Bornstein M M, Cionca N, Mombelli A . Systemic conditions and treatments as risks for implant therapy. Int J Oral Maxillofac Implants 2009; 24 Suppl: 12–27.

    PubMed  Google Scholar 

  12. 12

    Mombelli A, Cionca N . Systemic diseases affecting osseointegration therapy. Clin Oral Implants Res 2006; 17: 97–103.

    Article  Google Scholar 

  13. 13

    Borgnakke W S, Anderson P F, Shannon C, Jivanescu A . Is there a relationship between oral health and diabetic neuropathy? Curr Diab Rep 2015; 15: 93.

    Article  Google Scholar 

  14. 14

    Chavarry N G, Vettore M V, Sansone C, Sheiham A . The relationship between diabetes mellitus and destructive periodontal disease: a meta-analysis. Oral Health Prev Dent 2009; 7: 107–127.

    PubMed  Google Scholar 

  15. 15

    Khader Y S, Dauod A S, El-Qaderi S S, Alkafajei A, Batayha W Q . Periodontal status of diabetics compared with nondiabetics: a meta-analysis. J Diabetes Complications 2006; 20: 59–68.

    Article  Google Scholar 

  16. 16

    Borgnakke W S, Ylostalo P V, Taylor G W, Genco R J . Effect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence. J Periodontol 2013; 84 (4 Suppl): S135–152.

    PubMed  Google Scholar 

  17. 17

    Simpson T C, Weldon J C, Worthington H V et al. Treatment of periodontal disease for glycaemic control in people with diabetes mellitus. Cochrane Database Syst Rev 2015; 11: Cd004714.

    Google Scholar 

  18. 18

    Engebretson S, Kocher T . Evidence that periodontal treatment improves diabetes outcomes: a systematic review and meta-analysis. J Periodontol 2013; 84 (4 Suppl): S153–169.

    PubMed  PubMed Central  Google Scholar 

  19. 19

    Li Q, Hao S, Fang J, Xie J, Kong X H, Yang J X . Effect of non-surgical periodontal treatment on glycaemic control of patients with diabetes: a meta-analysis of randomized controlled trials. Trials 2015; 16: 291.

    Article  Google Scholar 

  20. 20

    Sgolastra F, Severino M, Pietropaoli D, Gatto R, Monaco A . Effectiveness of periodontal treatment to improve metabolic control in patients with chronic periodontitis and type 2 diabetes: a meta-analysis of randomized clinical trials. J Periodontol 2013; 84: 958–973.

    Article  Google Scholar 

  21. 21

    Teeuw W J, Gerdes V E, Loos B G . Effect of periodontal treatment on glycaemic control of diabetic patients: a systematic review and meta-analysis. Diabetes Care 2010; 33: 421–427.

    Article  Google Scholar 

  22. 22

    Wang T F, Jen I A, Chou C, Lei Y P . Effects of periodontal therapy on metabolic control in patients with type 2 diabetes mellitus and periodontal disease: a meta-analysis. Medicine (Baltimore) 2014; 93: e292.

    Article  Google Scholar 

  23. 23

    Sun Q, Feng M, Zhang M et al. Effects of periodontal treatment on glycaemic control in type 2 diabetes patients; a meta-analysis of randomised controlled trials. Chinese J Physiol 2014; 57: 305–314.

    Article  Google Scholar 

  24. 24

    Mauri-Obradors E, Jane-Salas E, Sabater-Recolons Mdel M, Vinas M, Lopez-Lopez J. Effect of nonsurgical periodontal treatment on glycosylated haemoglobin in diabetic patients: a systematic review. Odontology 2015; 103: 301–313.

    Article  Google Scholar 

  25. 25

    Artese H P C, Foz A M, Rabelo M D et al. Periodontal therapy and systemic inflammation in type 2 diabetes mellitus: a meta-analysis. PLoS One 2015; 10: 14.

    Article  Google Scholar 

  26. 26

    Corbella S, Francetti L, Taschieri S, De Siena F, Fabbro M D . Effect of periodontal treatment on glycaemic control of patients with diabetes: A systematic review and meta-analysis. J Diabetes Investig 2013; 4: 502–509.

    Article  Google Scholar 

  27. 27

    Ismail A F, McGrath C P, Yiu C K Y . Oral health of children with type 1 diabetes mellitus: a systematic review. Diabetes Res Clin Pract 2015; 108: 369–381.

    Article  Google Scholar 

  28. 28

    Chrcanovic BR, Albrektsson T, Wennerberg A . Diabetes and oral implant failure: a systematic review. J Dent Res. 2014; 93 (9): 859–67.

    Article  Google Scholar 

  29. 29

    Javed F, Romanos G E . Impact of diabetes mellitus and glycaemic control on the osseointegration of dental implants: a systematic literature review. J Periodontol 2009; 80: 1719–1730.

    Article  Google Scholar 

  30. 30

    Chen H, Liu N, Xu X, Qu X, Lu E . Smoking, radiotherapy, diabetes and osteoporosis as risk factors for dental implant failure: a meta-analysis. PLoS One 2013; 8: e71955.

    Article  Google Scholar 

  31. 31

    Barasch A, Safford M M, Litaker M S, Gilbert G H . Risk factors for oral postoperative infection in patients with diabetes. Spec Care Dentist 2008; 28: 159–166.

    Article  Google Scholar 

  32. 32

    Gong Y, Wei B, Yu L, Pan W . Type 2 diabetes mellitus and risk of oral cancer and precancerous lesions: a meta-analysis of observational studies. Oral Oncol 2015; 51: 332–340.

    Article  Google Scholar 

  33. 33

    de Morais E F, de Paiva Macedo R A, da Silva Lira J A, de Lima K C, Borges B C D . Factors related to dry mouth and low salivary flow rates in diabetic elderly: a systematic literature review. Revista Brasileira de Geriatria e Gerontologia 2014; 17: 417–423.

    Article  Google Scholar 

  34. 34

    Mascarenhas P, Fatela B, Barahona I . Effect of Diabetes Mellitus Type 2 on Salivary Glucose–A Systematic Review and Meta-Analysis of Observational Studies. PLoS One 2014; 9: e101706.

    Article  Google Scholar 

  35. 35

    Suvan J . Periodontitis and type 2 diabetes mellitus: Phase 3 trial. BMC ISRCTN registry. 2017; ISRCTN83229304.

  36. 36

    Carramolino-Cuellar E, Tomas I, Jimenez-Soriano Y. Relationship between the oral cavity and cardiovascular diseases and metabolic syndrome. Med Oral Patol Oral Cir Bucal. 2014; 19: e289–e294.

    Article  Google Scholar 

  37. 37

    Darre L, Vergnes J N, Gourdy P, Sixou M . Efficacy of periodontal treatment on glycaemic control in diabetic patients: A meta-analysis of interventional studies. Diabetes Metab. 2008; 34: 497–506.

    Article  Google Scholar 

  38. 38

    Janket S J, Wightman A, Baird A E, Van Dyke T E, Jones J A . Does Periodontal Treatment Improve Glycemic Control in Diabetic Patients? A Meta-analysis of Intervention Studies. J Dent Res 2005; 84: 1154–1159.

    Article  Google Scholar 

  39. 39

    Kudiyirickal M G, Pappachan J M . Diabetes mellitus and oral health. Endocrine 2015; 49: 27–34.

    Article  Google Scholar 

  40. 40

    Renvert S, Roos-Jansaker AM, Claffey N . Non-surgical treatment of peri-implant mucositis and peri-implantitis: a literature review. J Clin Periodontol 2008; 35 (8 Suppl): 305–315.

    Article  Google Scholar 

Download references


We would like to acknowledge the support of Public Health England, the Royal College of Surgeons and the British Dental Association.

Author information



Corresponding author

Correspondence to J. E. Gallagher.

Additional information

Refereed Paper

Supplementary information

Appendix 1

Search terms (PDF 79 kb)

Appendix 2

Included papers (PDF 245 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

D'Aiuto, F., Gable, D., Syed, Z. et al. Evidence summary: The relationship between oral diseases and diabetes. Br Dent J 222, 944–948 (2017).

Download citation

Further reading


Quick links