title: Type 2 diabetes mellitus and 20 year incidence of periodontitis and tooth loss.
abstract: OBJECTIVE
  The objective of this study was to evaluate the prospective associations between type 2 diabetes mellitus (T2DM) and the risk of periodontitis and tooth loss.
  
  
  METHODS
  35,247 male participants of the Health Professionals Follow-Up Study who were dentate, free of periodontitis and cancer at baseline, were followed from 1986 to 2006. Data on self-reported diabetes, periodontitis, tooth loss and potential confounders were collected at baseline and biennially through mailed questionnaires. The multivariable adjusted relationships between diabetes and first report of periodontitis and tooth loss were estimated using time-varying Cox models.
  
  
  RESULTS
  There were 3009 incident self-reported periodontitis and 10,017 tooth loss events over 591,941 person-years. Men with T2DM showed a 29% (HR=1.29; 95% CI: 1.13-1.47) increased risk of periodontitis compared to those without, when adjusted for age, race, smoking, BMI, fruit and vegetable intake, physical activity, alcohol consumption and dental profession. Men with T2DM with total fruit and vegetable intake < median were 49% as likely to report incident periodontitis compared to those without T2DM (HR=1.49; 95% CI: 1.23-1.80; p-value for interaction=0.03). The multivariable adjusted risk of tooth loss was 1.10 (95% CI: 1.02-1.18).
  
  
  CONCLUSIONS
  Type 2 diabetes mellitus was associated with a significantly greater risk of self-reported periodontitis.
authors.affiliation: Brigham and Women's Hospital, Division of Preventive Medicine, 900 Commonwealth Avenue, 3rd Floor, Boston, MA 02215, United States.
authors.forename: Monik
authors.initials: M
authors.lastname: Jimenez
authors.forename: Frank B
authors.initials: FB
authors.lastname: Hu
authors.forename: Miguel
authors.initials: M
authors.lastname: Marino
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.forename: Kaumudi J
authors.initials: KJ
authors.lastname: Joshipura
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015986:Confounding Factors, Epidemiologic; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005500:Follow-Up Studies; D006282:Health Personnel; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016388:Tooth Loss / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D014481:United States / Q000453:epidemiology