HMN 2026: How Diabetes is tied to higher tooth and implant loss over 10 years

Diabetes is associated with complications in multiple organs, including the oral cavity. As a group, people with type 1 or type 2 diabetes are at higher risk for oral diseases. According to a new thesis by dentist Anna Trullenque Eriksson from the University of Gothenburg, people with diabetes have an increased risk of periodontitis (gum disease) and tooth loss, and the risk of inflammation and bone loss at dental implants was also higher.

The thesis is based on a comprehensive dataset from seven Swedish registers covering a long period, with a high degree of completeness. Eriksson’s research addresses the link between the systemic condition diabetes and the oral conditions periodontitis, tooth loss, and peri-implantitis (an inflammatory disease in the tissues surrounding dental implants). Compared with previous studies, the study sample is strikingly large, particularly for type 1 diabetes.

People with type 1 diabetes and poor control of blood sugar levels were found to have an increased risk of periodontitis and tooth loss, compared with matched controls without diabetes. However, no such differences were evident for those with continuously good glycemic control.

In the case of type 2 diabetes, the risk of periodontitis and tooth loss was elevated regardless of blood sugar control. The correlation was strongest when glycemic control was poor. In turn, periodontitis was linked to an increased risk of diabetes-related eye and kidney complications in both diabetes types.

Among individuals with dental implants, those with type 1 or type 2 diabetes were at higher risk of peri-implantitis and implant loss. Poor blood sugar control was a key factor in poor implant outcomes.

The risk of complete tooth loss was particularly high among people with diabetes who were also socioeconomically disadvantaged (lower income, less education), highlighting the importance of socioeconomic factors. Data from both Sweden and Denmark were considered.

The thesis reinforces previous evidence of a link between diabetes and oral diseases and stresses the importance of close collaboration between health care and dental care providers. The findings on dental implants are novel, suggesting that diabetes may affect long-term outcomes of implant therapy.

“Within the dental community, most are aware of the link between diabetes and impaired oral health.

“Our data support the notion that dental care should be part of diabetes prevention strategies,” Eriksson said.

Type 1 diabetes (analyses based on 86,273 individuals; mean age 43 years):

• 33.9% had lost one or more teeth over a 10-year period (25.3% among those with good glycemic control; 43.5% among those with poor control). Among matched controls without diabetes, 29.0% experienced tooth loss.
• 3.1% had lost five or more teeth over 10 years (good control: 1.0%; poor control: 5.6%). The corresponding figure for controls was 1.9%.

Type 2 diabetes (analyses based on 786,305 individuals; mean age 60 years):

• 46.1% had lost one or more teeth over a 10-year period (44.0% among those with good glycemic control; 54.9% among those with poor control). Among matched controls without diabetes, 37.8% experienced tooth loss.
• 7.0% had lost five or more teeth over 10 years (good control: 5.7%; poor control: 12.6%). The corresponding figure for controls was 3.7%.

The content is provided for information purposes only.