The Effect of Self-Reported Diabetes on Alveolar Bone Loss and Number of Missing Teeth

Rayyan A. Kayal1, Mohammed Almutadares2, Abdullah Algarni3, Khalid Alfaifi4, Maha A. Bahammam1, Turki Y. Alhazzazi5, *
1 Department of Periodontics, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudia Arabia
2 Department of Periodontic Resident, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudia Arabia
3 Department of Periodontic Resident, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
4 Department of Dental, Ministry of Health, Jeddah, Saudi Arabia
5 Department of Oral Biology, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudia Arabia

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© 2021 Kayal et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Oral Biology, King Abdulaziz University, Faculty of Dentistry, Saudia Arabia; E-mail:



Diabetes mellitus, a major public health problem worldwide, is a known risk factor for periodontitis.


This study aimed to investigate the effect of diabetes on periodontal health in a Saudi population by assessing alveolar bone level, and the number of missing teeth.


In this retrospective study, the dental records of 203 patients (30–70 years old) patients (diabetic group = 102; control = 101) who visited King Abdulaziz University, Faculty of Dentistry, were examined through panoramic radiography. Bone loss measurements were carried out using the Ramfjord teeth index, and the number of missing teeth was counted for both groups. Independent t-test was used for comparing the total average represented by two group means, while Chi-square test was utilized to establish relationships between categorical variables.


The diabetic group had a significant 1.35-fold higher mean total bone loss (3.59 ± 1.37) compared to the control (2.66 ± 1.05). This was statistically significant in both genders (p = 001) and in >45 years old age group (p <0.05). The number of missing teeth was significantly higher in diabetic patients compared to control patients, specifically when missing >10 teeth and belonging to >55 years old age group (p <0.05).


Our findings have shown a positive association between periodontal disease and diabetic patients, emphasizing the importance of early screening and diagnosis of diabetes and periodontitis in Saudi Arabia, which would help patients to avoid alveolar bone and tooth loss at early stages.

Keywords: Alveolar bone loss, Diabetes mellitus, Periodontitis, Saudi arabia, Teeth, Risk factor.