Results presented June 17, 2022, at EuroPerio10—a conference that has been established as "the world's leading congress in periodontology and implant dentistry"—highlighted research that identifies severe gum disease, otherwise described as periodontitis stages III and IV, as a condition associated with elevated HbA1c levels, diabetes, and myocardial infarction. Access to their sessions can be found on the EuroPerio10 website.

Dr. Ida Stødle of the University of Oslo, Norway, and colleagues embarked on a research initiative to explore whether elevated HbA1c, the diagnosis of diabetes, or experience of prior myocardial infarction was associated with a greater likelihood of having severe gum disease. In order to eliminate potential study bias, their data analysis adjusted for the subject's age, waist circumference, level of physical activity, serum cholesterol, and smoking status. After these adjustments, the research team reported that elevated HbA1c, prior heart attack, or severe gum disease were significantly associated with diabetes (odds ratios of 1.4, 1.5, and 1.7, respectively).

The HUNT Study cohort of roughly 5,000 individuals was comprised of 56% women, with the average participants aged 52 years. A total of 3.0% (n = 147) participants reported a prior heart attack, 4.5% (n = 224) indicated they had diabetes, 3.3% (n = 165) reported elevated HbA1c (48 mmol/mol or above), and 17.6% (n = 866) reported severe gum disease (periodontitis).

Subjects completed questionnaires that explored lifestyle factors, use of medications, presence of diagnosed diseases such as type 2 diabetes, previous myocardial infarction, as well as sociodemographic criteria. A clinical assessment of both soft tissues and teeth was performed, which included dental radiological examination.

According to Dr. Stødle, "This was an observational study and does not imply causal relationships." She further elaborated, "However, the findings raise awareness about the correlations between chronic illnesses which affect large numbers of people. This knowledge may help efforts to prevent these diseases."

Dr. Stødle explained, "The presence of diabetes was assessed from self-reported questionnaires and may include a broad spectrum of severity, from poorly controlled to well controlled. For this reason, we also examined the relationship between gum disease and HbA1c, which indicates average blood sugar levels over the last two to three months. Patients with diabetes are at higher risk of diabetic complications when their HbA1c levels are 48 mmol/mol or above."

Dr. Stødle concluded, "The results show that patients with diabetes were 40% more likely to have severe gum disease than those without diabetes. Participants with high HbA1c were 50% more likely to have severe gum disease than those with HbA1c levels below 48 mmol/mol. Finally, heart attack survivors were 70% more likely to have severe gum disease than participants who had never experienced a heart attack."

She further stated, "This study builds on previous evidence suggesting that people with gum disease are at greater risk of having a heart attack and developing diabetes, and also that those with diabetes are at greater risk of getting gum disease. Taken together, the findings indicate that maintaining oral health could also benefit general health."

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