Oral health and incident type 2 diabetes among older men: a longitudinal analysis from the British Regional Heart Study

Background
Type 2 diabetes is linked to a high prevalence of oral health problems, but whether poor oral health contributes to diabetes risk remains unclear. This study examined the association between various oral health markers and the incidence of type 2 diabetes.

Methods
Data were derived from the British Regional Heart Study cohort of men aged 71–92 years (n=2147) across 24 UK towns. Oral health markers included tooth count, periodontal disease, dry mouth, self-rated oral health, denture use, and associated difficulties. Participants were followed for 8 years (2010–2018) for diabetes incidence using General Practice records. Cox regression models adjusted for age, BMI, social class, smoking, alcohol use, physical activity, and medical history.

Results
Among 1908 men without diabetes at baseline, 78 developed diabetes during follow-up. Significant associations with diabetes risk were observed for complete tooth loss (Hazard ratio (HR)=4.03, 95% Confidence Interval (CI) =1.83–8.86), poor/fair self-rated oral health (HR=2.63, 95% CI=1.50–4.62), denture use or no dentures among those with no natural teeth (HR=2.91, 95% CI=1.36–6.22), and having ≥2 oral health problems causing difficulty in daily tasks (HR=3.10, 95% CI=1.27–7.55).

Conclusion
Poor oral health, including tooth loss, poor self-rated oral health, and difficulties associated with oral health problems, was significantly linked to an increased risk of developing type 2 diabetes in older adults. Further research is needed to clarify the underlying mechanisms and explore whether improving oral health can reduce the risk of diabetes in older men.