Obesity & Diabetes

The oral-systemic link between obesity and oral disease is intimately tied up with diabetes in a "three-way street."

  • Fat tissue is a metabolically-active organ that produces tumor necrosis factor alpha (TNF α) and interleukin 6.
  • These cytokines promote bone breakdown and inflammation, processes that both potentiate periodontal disease.
  • TNF α also causes insulin resistance that predisposes to Type 2 diabetes.
  • Poor glycemic control is associated with periodontal disease.
  • Periodontal disease then leads to worsening glycemic control, creating a vicious cycle.


Diabetes & Glycemic Control

  • Poor glycemic control is associated with a threefold increased risk of having periodontitis in diabetics versus controls.
  • Diabetics with good glycemic control have no significant increased risk of periodontal disease.
  • Chronic infection (like periodontal disease) worsens glucose control.
  • Treatment of periodontal disease results in a 10–20% improvement in glycemic control.


Genco R.  The Three-Way Street. From: Scientific American, Oral and Whole Body Health. October 2006.

Mealey BL. Periodontal disease and diabetes: A two-way street. J Am Dent Assoc. 2006; 137: 26-31.

Simpson TC, Weldon JC, Worthington HV, et al. Treatment of periodontal disease for glycaemic control in people with diabetes mellitus. Cochrane Database Syst Rev. 2015 (11): CD004714.