Encías y diabetes: conexión bidireccional
Cuidar las encías puede controlar la diabetes tan eficazmente como un segundo fármaco, revela estudio
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Treating gum disease may lower blood sugar as effectively as adding a second diabetes drug, according to a new report by Donte Group. The Spanish dental chain found that a professional periodontal cleaning can reduce glycated hemoglobin — the key marker doctors use to track diabetes — by around 0.4%. For a Type 2 diabetic, that drop is comparable to the effect of adding sitagliptin to a metformin regimen.
The report, released in June 2024, highlights what scientists call a "bidirectional relationship" between gum disease and diabetes. Each condition makes the other worse. And treating one, the data suggests, measurably improves the other. El Periódico and more than a dozen Spanish outlets picked up the findings, reigniting a debate over whether dental care belongs inside public health systems.
How Gums and Blood Sugar Make Each Other Worse
The biology runs in two directions. High blood sugar weakens white blood cells, making the body less able to fight off bacterial infections in the gums. That leads to periodontitis — a chronic inflammation of the tissue around the teeth. According to Levante-EMV, people with diabetes are three times more likely to develop gum disease than people without it.
Then the damage reverses course. Bacteria from infected gums enter the bloodstream. The body responds by releasing pro-inflammatory proteins called cytokines. Those cytokines block insulin receptors, raising insulin resistance. Blood sugar climbs. The loop closes. Donte Group's medical director, Dr. Clara Esteban, put it plainly: "treating the mouth is treating the patient's metabolic future."
The "Second Drug" Comparison That Changed the Conversation
The report's boldest claim is the drug comparison. A reduction of 0.4% in HbA1c — the glycated hemoglobin level — is small but medically meaningful. It sits in the same range as what doctors expect when they add a second oral antidiabetic pill to a patient's treatment. According to La Opinión de Málaga, the Cochrane Library and Donte Group's own clinical data both support this figure.
Donte Group CEO Javier Martín framed this as a system-wide problem. "Oral health can no longer be treated as an isolated island from the rest of the body's health," he said. The group operates more than 400 clinics across Spain — under brands including Vitaldent and Moonz — giving it one of the largest dental data pools in the country.
Skeptics Warn Against Ditching Pills for Dentist Visits
Not everyone is convinced the comparison holds up. Some medical researchers point to what they call a "healthy user bias." Patients who brush and floss regularly also tend to exercise more and eat better. So the drop in HbA1c might not come from the gum treatment alone. El Correo Gallego noted that critics in medical journals argue the "second drug" analogy oversimplifies a complex disease.
Public health experts stress that periodontal care should work alongside medication — not replace it. Donte Group itself does not argue otherwise. But the framing matters, especially when patients may hear "dentist as good as a drug" and make decisions on their own. The report calls gum care an adjunct tool, not a substitute.
Spain Now Faces Pressure to Fund Dental Care for Diabetics
The report lands at a politically sensitive moment. Around 1 in 7 adults in Spain has Type 2 diabetes. Globally, 537 million people live with the condition — a number the International Diabetes Federation expects to hit 783 million by 2045. According to LNE, Donte Group estimates that preventative oral care costs roughly one-tenth of treating an acute diabetic crisis.
Lobbyists are now pushing Spain's Ministry of Health to include periodontal cleanings for diabetic patients in the public health system. Annual savings per patient in avoided complications could reach between €1,500 and €3,000, according to data cited by El Periódico de Aragón. The government has so far called for "further long-term studies" — language critics say is a way to delay a costly budgetary shift.
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