GLP-1-receptor agonist therapies and periodontal disease: a retrospective pilot cohort study

Abstract Background Periodontal disease and type 2 diabetes share inflammatory pathways. GLP-1-RAs may modulate these pathways, but their effect on clinical periodontal outcomes has yet to be clearly investigated. Methods We conducted a retrospective cohort study of adults with type 2 diabetes receiving routine dental care. Cross-sectional ( n = 132) and longitudinal ( n = 70) analyses compared GLP-1-RA users with non-users. Multivariable linear, quasi-Poisson, and logistic regression adjusted for age, BMI, gender, smoking, periodontal surgery, and follow-up duration. Linear and quasi-Poisson models additionally adjusted for the corresponding baseline periodontal measure. Results GLP-1-RA usage was not associated with probing depth change (B = 0.002; 95% CI, –0.262 to 0.265; P = 0.988). Estimates for PD ≥ 5-mm site count (RR = 0.650; 0.365 to 1.136; P = 0.140) and odds of exploratory relative response (OR = 2.609; 0.861 to 8.286; P = 0.094) were directionally favorable but did not reach statistical significance. Conclusions GLP-1-RA usage was associated with directionally fewer pockets with PD ≥ 5 mm and higher odds of meeting the exploratory ≥ 50% relative-reduction criterion, though statistical significance was not achieved. The preliminary findings of this pilot study do not confirm a periodontal benefit but warrant evaluation in adequately powered prospective studies in order to better inform clinical guidelines.