Association between decreased occlusal support and diabetes mellitus diagnosed by the oral glucose tolerance test with and without periodontal disease: The Suita Study

Purpose: Several studies have reported a close association between periodontal disease (PD) and diabetes mellitus (DM). In addition, the decline in masticatory function due to decreased occlusal support may worsen DM due to poor nutritional intake. We aimed to elucidate the relationship between PD, decreased occlusal support, and DM.

Methods: We surveyed 968 participants (411 men and 557 women) aged 50-79 years in the Suita study. An oral glucose tolerance test was performed with 75 g glucose, and fasting and 2 h post-challenge plasma glucose levels were measured. The participants were classified into following four groups: normal glucose tolerance, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and DM. Occlusal support was evaluated by the Eichner Index. PD was assessed using the Community Periodontal Index, and participants were classified into two groups: without PD and with PD. Logistic regression analysis was performed using the incidence of IFG, IGT, and DM as objective variables in the without PD and PD groups.

Results: In the without PD group, body mass index (BMI) was significantly associated with IFG, IGT, and DM, and a history of hypertension was significantly associated with DM. In the PD group, male sex and BMI were significantly associated with IGT and DM, a history of hypertension was significantly associated with DM, and decreased occlusal support was significantly associated with IGT and DM.

Conclusions: Decreased occlusal support was associated with DM in patients with PD.