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J Clin Periodontol. 2009 Sep;36(9):765-74. doi: 10.1111/j.1600-051X.2009.01445.x. Epub 2009 Jul 20.

Association between type 1 and type 2 diabetes with periodontal disease and tooth loss.

Author information

  • 1Unit of Periodontology, Department of Restorative Dentistry, Periodontology, and Endodontology, Dental school, University of Greifswald, Greifswald, Germany.

Erratum in

  • J Clin Periodontol. 2009 Dec;36(12):1075. Rathmann, Wolfgan G [corrected to Rathmann, Wolfgang].



The aim of this study was to determine whether both type 1 (T1DM) and type 2 diabetes mellitus (T2DM) are associated with increased prevalence and extent of periodontal disease and tooth loss compared with non-diabetic subjects within a homogeneous adult study population.


T1DM, T2DM and non-diabetic subjects were recruited from the population-based Study of Health in Pomerania. Additionally, T1DM subjects were retrieved from a Diabetes Centre. The total study population comprised 145 T1DM and 2647 non-diabetic subjects aged 20-59 years, and 182 T2DM and 1314 non-diabetic subjects aged 50-81 years. Periodontal disease was assessed by attachment loss (AL) and the number of missing teeth.


Multivariable regression revealed an association between T1DM (p<0.001) and T2DM (p<0.01) with mean AL after full adjustment. After age stratification (p=0.04 for interaction), the effect of T2DM was only statistically significant in the 60-69-year-old subjects (B=0.90 (95% confidence intervals [95% CI]; 0.49, 1.31). T1DM was positively associated with tooth loss (adjusted, p<0.001). The association between T2DM and tooth loss was statistically significant only for females (odds ratios=1.60 [95% CI: 1.10, 2.33]).


Our study confirmed an association between both T1DM and T2DM with periodontitis and tooth loss. Therefore, oral health education should be promoted in diabetic subjects.

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