New Study Shares How Poor Oral Health Is Linked To Diabetes And Muscle Loss

In an older study, research has shown that poor oral health is linked to cardiovascular disease and even death from different types of causes.

And in a new study, scientists looked into how patients that have less teeth or few remaining teeth alongside the inability to chew, and how it’s associated with an increased risk of muscle weakness, muscle loss, and even diabetes in the elderly.

By simply improving one’s oral health, and by using dentures to lessen the chances of losing whatever teeth are left, could have a beneficial impact on preventing these negative health conditions in the future.

Another incidental negative consequence of the global COVID-19 pandemic is the fact that people weren’t able to see their dentists to have their usual routine care and cleaning. Moreover, the quarantine caused forced lockdowns and restricted access to dental services, which meant people’s oral hygiene suffered greatly because of it.

A survey conducted in the United Kingdom shared how one particular impact was the major backlog of patients, causing delays in patient appointments with the National Health Service dentistry. Because of this, some patients have even opted to pay extra to get private care instead of waiting for their supposed schedule.

Anyone that has suffered from a toothache knows just how painful it can be. But aside from the physical discomfort that comes along with dental issues, according to research, poor oral health has been linked to an increased risk of cardiovascular disease.

During a longitudinal study, it was discovered that “oral frailty,” which is a measure that considers the number of one’s remaining teeth, their difficulty of eating and swallowing, and their ability to chew, was an increased risk for disability, physical frailty, and even mortality from a number of different causes, especially in the elderly.

This new study, which was led by a group of researchers from the Shimane University in Izumo, Japan, also saw ‘small but significantly increased risks’ of diabetes, as well as sarcopenia – which is the loss of muscle and weakness because of getting older – amongst older individuals with notable oral frailty.

The research paper was published in the PLOS ONE journal. One author wrote, “Although oral health might affect the overall health of an individual, it has been neglected in the public health domain.”

Doing an Annual Health Examination

The research group shared that their analysis was part of the university’s Center for Community-Based Healthcare Research and Education study. They collaborated with the annual health examination program in the small town of Ohnan, which is located in Japan’s Shimane prefecture.

For the study, there was a total of 635 people involved, all between the ages of 40 and 74.

In order for the researchers to assess their chewing abilities, otherwise known as “masticatory function,” the researchers had the participants chew a gummy jelly ‘as energetically as possible for 15 seconds without swallowing it,’ then having them spit out whatever was left.

After which, the team counted the amount of candy pieces that were left. They also counted the number of teeth each participant had, as well as measured their calf circumference for both legs twice, along with their skeletal muscle mass and handgrip strength.

In order to assess their sarcopenia, the researchers did a standard diagnostic algorithm that that includes muscle mass, strength and physical performance.

The research group also took into account ‘the participants’ self-reported diagnoses of diabetes’ while doing actual screening on them for diabetes by testing their serum hemoglobin A1C levels.

To get a more precise outcome, the researchers adjusted their results by taking into account the participants’ age, gender, body mass index, alcohol consumption, smoking status and their level of physical activity.

What they discovered was that for those with less or fewer remaining teeth and weak or inadequate chewing ability were substantially associated with a poor handgrip and possible sarcopenia. Moreover, having less teeth and inadequate chewing ability were also considerably linked to diabetes.

Meanwhile, the study found that there were no statistically significant associations with skeletal muscle mass or calf circumference.

Other Possible Links with Diabetes

According to the researchers, “Our findings suggest that improvement in oral health, including the maintenance of masticatory function and remaining teeth, may contribute to the prevention of sarcopenia and diabetes mellitus in older adults.”

They also theorize that for people with decreased chewing ability of less teeth may also have ‘an increased risk of diabetes as a result of eating more soft, sugar-rich foods and having shorter mealtimes.’

These factors could also cause a higher spike in blood glucose levels after a meal.

According to research, by preventing tooth loss through the use of dentures could also maintain one’s chewing ability and therefore lessen any chance of such aging-related conditions in the first place.

In an interview with Medical News Today, Senior author Shozo Yano, M.D., Ph.D. said, “According to our data, improving mastication and denture use may reduce the risk of diabetes and sarcopenia.”

The study authors also share evidence that gum disease – which often leads to tooth loss – could also ‘lead to decreased insulin sensitivity and impaired glucose tolerance.’

Dr. Yano, who happens to be a part of the Nutrition Support Team at Shimane University Hospital, shares, “Loss of teeth is strongly related to periodontal disease and probably to systemic inflammation, which may play a role in the pathogenesis of diabetes and sarcopenia.”

Dr. Yano also advised the elderly to eat slower than usual, as well as brush their teeth after every single meal. In the process of taking better care of their oral health, older people will also maintain their overall health as well.

Study Limitations

While the study did identify associations between oral frailty, sarcopenia and diabetes that were considered statistically significant, they were also relatively small, in the order of 2-6%. The authors conclude that by increasing the number of patients, it will also lead to a much more statistically powerful association.

Meanwhile, the research group also admits that because of its cross-sectional design, the study wasn’t able to find any causal relationships. Moreover, they also did not account for other significant oral health features like brushing teeth, denture use, and gum disease.

The authors conclude, “Thus, future longitudinal studies are essential for investigating these associations.”