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Patients with diabetes need to pay close attention to their dental health. A study of 628 Pima Indians 35 years of age or older with type 2 diabetes indicated that periodontal disease strongly predicts mortality from heart disease and kidney disease. To investigate, the researchers used dental x-rays and examinations to determine if the participants had periodontal disease. The gum disease was classified as none, mild, moderate, or severe.
Reporting in Diabetes Care (January 2005), the researchers discovered that 60% of the participants had severe periodontal disease. Of the 60%, 263 (70%) of the participants had lost all their teeth. In the follow-up phase, an average of 11 years, 204 of the participants had died. The researchers said that the death rates for all natural causes "expressed as the number of deaths per 1000 person-years of follow-up were 3.7 for no or mild periodontal disease, 19.6 for moderate disease, and 28.4 for severe periodontal disease."