The association between dental prophylaxis and diabetes outcomes: A 15-year cohort study

Periodontal disease and diabetes share inflammatory pathways. Dental prophylaxis (DP) is effective in preventing periodontal inflammation; however, its association with diabetes outcomes remains unclear. This study aims to evaluate the association between DP intensity and mortality and diabetes-related complications among adults with newly diagnosed type 2 diabetes.

We conducted a retrospective cohort study using Taiwan's National Health Insurance Research Database (2005-2022). Adults aged 18-70 years with incident type 2 diabetes in 2007 were identified, with 2005-2006 as the washout period. Participants were followed from 2008 until death or December 31, 2022. Annual DP intensity was categorized as none (0), moderate (1), or high (2-4). Outcomes included all-cause mortality and the Diabetes Complications Severity Index (DCSI). Marginal structural models with stabilized inverse probability of treatment weighting addressed time-dependent confounding. Weighted Cox regression was used to estimate mortality, and a weighted generalized estimating equation was used to evaluate DCSI.

There were 117,968 patients. Compared with 0 DPs, receiving 1 DP/year and ≥2 DPs/year were associated with lower mortality (adjusted hazard ratios: 0.32 for 1 DP/year; 0.11 for ≥2 DPs/year) and DCSI (β: -0.01 for 1 DP/year; -0.02 for ≥2 DPs/year), indicating a dose-response relationship.

Greater DP intensity was associated with lower mortality and fewer DCSI. Offering basic dental insurance to all and integrating preventive dental care into standard diabetes care could complement efforts to mitigate the rising global burden of type 2 diabetes.