Relationship between oral health, diabetes management and sleep apnea

Ayse Basak Cinar, Inci Oktay, Lone Schou

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


Objectives: The aim of this study was to assess the relationship between tooth loss, toothbrushing behaviour, diabetes type 2 (DM2), obesity and sleep apnea among diabetics. Material and methods: DM2 patients (n = 165) in Istanbul, Turkey, were randomly selected from the outpatient clinics of two hospitals. Baseline clinical measurements (HbA1c, fasting blood glucose, high-density lipoprotein (HDL), low-density lipoprotein (LDL), body mass index (BMI), body-fat proportion, tooth loss) and self-administered questionnaires (toothbrushing, gingival bleeding, sleep apnea) provided data for factor and principal component analysis with Varimax rotation. Univariate statistics and chi-square tests were derived. Results: Mean maxillary tooth loss (4. 49 ± 3. 69 teeth) was higher than in the mandible (3. 43 ± 3. 12 teeth, p< 0. 001). Favourable HDL was measured among most patients (77 %); other favourable clinical measures occurred only in a minority of participants (HbA1c, 28 %; fasting blood glucose, 17 %; LDL, 30 %). Twice daily toothbrushing was reported by 33 % (17 %) for healthy BMI; 37 % when healthy body-fat proportions. There was risk of sleep apnea in 37 %. The higher number of lost teeth in the maxilla was linked with obesity and sleep apnea. Non-daily toothbrushers were more likely to have high LDL and low HDL cholesterol and a higher risk of sleep apnea. When "at least occasionally" bleeding on toothbrushing occurred, higher HbA1c levels and sleep apnea were more likely. Conclusion: Oral care with early diagnosis and monitoring of glycaemic level can help prevent complications of DM2. Clinical relevance: Dentists may play a key role in better managing and diagnosing sleep apnea early by referring the patients with severe tooth loss and periodontal disease for general medical examination.

Original languageEnglish
Pages (from-to)967-974
Number of pages8
JournalClinical Oral Investigations
Issue number3
Publication statusPublished - Apr 2013


  • BMI
  • Diabetes
  • Sleep apnea
  • Tooth loss
  • Toothbrushing

ASJC Scopus subject areas

  • General Dentistry


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