A University at Buffalo researcher recommends medical professionals treating patients with type 2 diabetes (T2D) examine their patients’ teeth. The study findings, published April 14 in PLOS ONE, show that T2D patients with complete masticatory function had significantly lower blood glucose levels than patients with poor mastication. Eskan works as a clinical assistant professor in the Department of Periodontics and Endodontics at the UB School of Dental Medicine. Data from 94 T2D patients seen at an outpatient clinic at a hospital in Istanbul, Turkey were examined in a retrospective analysis. Patients were divided into two groups. The first group included patients who had strong “occlusion function”—enough teeth that were correctly positioned and making contact with each other to allow for efficient food chewing. The blood sugar level for that group was 7.48. The other group’s blood sugar level was higher than 2 percent at 9.42, and they could barely chew because of missing part or all of those teeth.
When you sit down at a picnic table with family and friends, munch — munch — is the last thing on your mind. However, several things begin to happen as soon as you bite into your burger. Digestion, the process by which your body extracts nutrients from food, chewing stimulates the production of saliva. Important nutrients for lowering blood sugar levels include fiber, which is achieved in large part by proper chewing of foods. Chewing has also been reported to stimulate responses in the intestines that lead to increased insulin secretion, and the hypothalamus that promote feelings of satiety, resulting in less food intake. Eating less reduces the likelihood of being overweight, which is a major risk factor for developing T2D.
Eskan received his DDS from Hacettepe University, a leading medical research center in Turkey, and earned his PhD at the University of Louisville, where he also completed a residency in Periodontology. “My particular clinical interest is in treating dental patients who are systemically compromised,” he said. His research goal is to contribute to the big picture of improving public health. This research notes that, as of 2019, nearly half a billion people worldwide had diabetes, and at least 90% of patients with diabetes have T2D.
Addressing oral health has recently become part of the approach to managing diabetes, along with encouraging patients to maintain a healthy weight, eat a healthy diet, and quit smoking. “Our findings suggest that there is a strong association between chewing and control of blood glucose levels in T2D patients,” Eskan said. This study did not find any independent variables that could affect blood glucose levels between subjects as there were no statistical differences between subjects regarding body mass index (BMI), gender, smoking status, medications or infections As indicated by white blood cell count (WBC) at baseline.
The dramatic improvement in one patient’s case described in a 2020 study co-led by Askin illustrates the potential benefit of improving occlusal function through dental implants and appropriate fixed restorations. A T2D patient whose chewing function was severely impaired due to missing teeth initially presented with a blood glucose level of 9.1. The patient received nutrition by using a bottle and eating baby food. Four months after treatment with a full mouth implant-supported fixed restoration, the patient’s glucose level dropped to 7.8. After 18 months it decreased to 6.2.
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Research has shown that just a 1% increase in blood sugar levels in people with diabetes is associated with a 40 percent increase in cardiovascular or ischemic heart disease mortality, according to Ascan. Other complications can include kidney disease, eye damage, neuropathy, and slow healing of simple wounds such as cuts and blisters. “I’m interested in research that can improve people’s health now,” Eskan said. He and co-author Yeter E. Bayram, MD, Department of Internal Medicine, Hamidiye Sisli Etfal Education and Research Hospital in Istanbul, look forward to further studies that explore the possible causal relationship between occipital support and blood sugar levels. .