Exploring the association between prophylaxis and diabetic complications among adults with diabetes and periodontal disease

Background: The bidirectional relationship between periodontal disease (PD) and diabetes is well-established, although the impact of periodontal treatment on diabetes-related complications (DRCs) remains understudied. The authors explored the association between PD and DRCs in patients with type 2 diabetes mellitus (T2DM) and PD. Methods: A matched retrospective cohort analysis was conducted using electronic health records data for patients older than 18 years who received a diagnosis of both T2DM and PD. The treatment group had at least 1 examination and prophylaxis and a corresponding International Classification of Diseases, 10th Revision diagnosis code for PD (proxy for periodontal treatment) and the control group had none. Glycated hemoglobin levels and incidence of at least 1 DRC were compared between groups over a 1-year period postintervention. E-values were used to assess how robust findings were to unmeasured confounding. Results: After matching, each group comprised 3,559 patients. The treatment group had lower mean glycated hemoglobin (7.22% vs 7.52%; absolute difference, –0.30 percentage points; 95% CI, –0.38 to –0.22 percentage points) and lower DRC incidence (9.20% vs 14.30%; relative risk reduction, 36%; 95% CI, 23% to 46%). This reduction was consistent across most categories of sex and race and ethnicity. The E-values (1.56-3.68) suggest confounding variables would need moderate to strong associations with both exposure and outcome to negate the observed associations. Conclusions: Among patients with T2DM and PD, periodontal treatment was associated with improved glycemic control and reduced DRC risk across sociodemographic subgroups. This consistent risk reduction suggests periodontal treatment may be widely applicable in diabetes management. Practical Implications: The study findings support recommendations to integrate regular oral health care into comprehensive diabetes management.