Chewing Your Way to Better Health

If you’re one of the millions of people worldwide with Type 2 diabetes (T2D), University at Buffalo researcher Mehmet A. Eskan has a suggestion for you: Get your teeth checked.

That’s because a recent study co-authored by Eskan, a clinical assistant professor in the School of Dental Medicine, showed a significant correlation between the ability of a patient with T2D to chew properly and their blood glucose level.

The retrospective study looked at data gathered from 94 patients with T2D. The patients were divided into two groups. The first group included patients with good “occlusal function,” i.e., enough teeth placed properly and making contact in such a way that food was well chewed. That group’s average blood glucose level (HbA1c) was 7.48. The second group couldn’t chew well, if at all, because they were missing teeth; their average blood glucose level was almost 2% higher, at 9.42.

Those numbers matter. Research has shown that an increase of just 1% in blood glucose level is associated with a 40% increase in cardiovascular or ischemic heart disease mortality among people with diabetes. Other complications can include kidney disease, eye damage, neuropathy and slow healing of simple wounds.

The science of chewing is probably the last thing on your mind when you sit down to eat. However, when you take a bite of food, several things start to happen. Chewing stimulates the production of saliva, which begins the process of digestion, in which your body extracts nutrients from food. Nutrients like fiber are key to reducing blood glucose levels. Chewing also has been reported to stimulate reactions in the intestine that lead to increased insulin secretion, and in the hypothalamus that promote a feeling of satiety, resulting in less food intake. Eating less decreases the likelihood of becoming overweight, which is a major risk factor for developing T2D.

The dramatic improvement in one patient’s case, described in a 2020 study co-led by Eskan, illustrates the potential benefit of improving occlusal function. A T2D patient whose chewing function was severely impaired by missing teeth presented initially with a blood glucose level of 9.1. The patient obtained nutrition by using a bottle and eating baby food. Four months after treatment with a full-mouth implant-supported fixed restoration, the patient’s average blood glucose level dropped to 7.8. After 18 months, it decreased to 6.2.

Eskan noted his research goal is to contribute to the big picture of improving public health. “My special clinical interest is to treat dental patients who are systemically compromised,” he said. “I’m interested in research that can improve people’s health now.”