Oral disorders prevalent in patients with diabetes

A study reports a strong correlation between diabetes and oral pathologies, particularly malignancies and periodontal disease.

“[In this study,] the risk of developing various oral and systemic conditions was significantly higher among diabetic vs nondiabetic individuals … One of the most important findings is the significantly higher risk of malignant tumours in diabetic patients,” the investigators said.

The estimated risk of malignant tumours was nearly sixfold higher among patients with vs without diabetes (15 percent vs 1.4 percent; relative risk [RR], 5.29; p=0.001). [Dent J (Basel) 2025;13:373]

“[T]his association deserves close attention. Diabetes creates an unfavourable biological environment, marked by chronic inflammation, oxidative stress, and weakened immune responses, which can contribute to the development and progression of oral cancers,” the researchers noted.

“These findings highlight the importance of including regular screening for malignant lesions as part of routine care for diabetic patients, through close collaboration between dental professionals and other healthcare providers involved in managing chronic diseases,” they continued.

Periodontal pathologies

The diabetes group also had higher incidences of periodontal disease (5.5 percent vs 0.6 percent; RR, 4.66), apical periodontitis (5.3 percent vs 1 percent; RR, 3.53), periapical cysts (2.4 percent vs 0.7 percent; RR, 2.55), and root remnants (9 percent vs 6.1 percent; RR, 1.43; p=0.001 for all) compared with those who did not have diabetes.

“Diabetes is an important risk factor for periodontal disease, as hyperglycaemia promotes chronic inflammation, affecting the supporting structures of the teeth and accelerating the progression of periodontitis,” they explained.

“This relationship is two-way – while high blood sugar can worsen periodontitis, the presence of this oral disease can also make it harder for diabetic patients to keep their blood glucose levels under control,” the researchers continued.

Regular dental checkups warranted

To ascertain the prevalence and distribution of oro-maxillofacial pathologies in patients with diabetes, the researchers retrospectively evaluated 6,868 patients (mean age 49.84 years, 57.2 percent men). Of these, 925 patients (13.5 percent) were diagnosed with diabetes. Diabetes was more frequent in men (58.7 percent; RR, 1.06), in individuals >54 years (50.6 percent; RR, 1.01), and in patients from urban areas (50.7 percent; RR, 1.15).  

Approximately 3 percent (n=222) had malignant tumours in the oral and maxillofacial region, 6.5 percent (n=444) had root remnants, 1.6 percent (n=107) had apical periodontitis, 1.2 percent (n=85) had periodontal disease, and 1 percent (n=66) had periapical cysts. Patients with diabetes had a higher probability of having periapical cysts (RR, 2.55; p=0.001).

“[O]ur results provide further evidence on the emerging acknowledgment that the systemic complications of diabetes, resulting from its multiple pathophysiological mechanisms, go beyond classical metabolic disorders,” the investigators said.

The findings underpin the need for early screening, preventive care, and targeted management strategies for individuals with diabetes, the researchers said. These patients are thus encouraged to undergo regular dental check-ups and treatments to reduce the risks of oral and maxillofacial complications. Early specialist referral is highly recommended for patients with poorly controlled disease.

“Future research should aim to explore the mechanisms behind the observed associations in greater depth, ideally through prospective, longitudinal studies that monitor patients over time,” the researchers said.

They added that further trials should evaluate clinical (eg, glycaemic control, diabetes duration, medication use, lifestyle habits) and laboratory (eg, systemic inflammatory markers, salivary biomarkers, microbial profiles) variables to shed light on the underlying mechanisms and biological pathways involved.