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Glucose, diabetes and oral health

There's good news to report for patients who have type 2 diabetes and gum disease: regular dental treatment could potentially lower blood glucose levels.

Gum disease—or periodontal disease—is an infection of the gum and bone that hold teeth in place. Diabetes reduces the body's resistance to infection, so the gums are among the tissues likely to be affected. In the early stages of periodontal disease—called periodontitis—the gums can become red, swollen and bleed easily. At this stage, the disease is still reversible.

The new research evaluates studies of patients age 16 and older with type 1 (juvenile onset) or type 2 (adult onset) diabetes and periodontitis. Reviewers found that treating periodontitis could have small yet beneficial implications for people with type 2 diabetes; however, the review did not show enough evidence to support beneficial implications for people with type 1 diabetes.

The review by lead author Dr. Terry Simpson of the Edinburgh Dental Institute in Scotland appears in The Cochrane Library, a publication of The Cochrane Collaboration, which evaluates medical research based on the content and quality of existing medical trials.

"It would be wise to advise these patients of the relationship between treating periodontal disease and the possibility of lowering their blood sugar levels," said Dr. Simpson. "Additionally, an oral health assessment should be recommended as part of their routine diabetes management."

Dr. Simpson also cautioned that larger studies are necessary to further analyze periodontal treatment and outcomes.

According to the American Dental Association, periodontal disease is often linked to the control of diabetes. For example, patients with inadequate blood sugar control appear to develop periodontal disease more often and more severely, and they lose more teeth than patients who have good control of their diabetes.

Because of lowered resistance and a longer healing process, periodontal diseases often appear to be more frequent and more severe in diabetic patients. Good maintenance of blood sugar levels, a well-balanced diet, good oral care at home, regular dental checkups and periodontal examinations are important.

Perhaps most importantly, controlling blood glucose is a potentially life-saving measure. High blood glucose can put people at risk for heart disease, stroke, kidney disease and other health problems.

Said Dr. Simpson: "Treatment can reduce the amount of bacteria and inflamed tissue in the gums. The presence of bacteria and inflamed tissue is thought to produce chemical changes which affect the action of insulin and in turn raises the circulating levels of sugar in the bloodstream. By resolving this with periodontal treatment, the patient might experience a lower blood sugar level over a period of time."

©2010 American Dental Association. All rights reserved. Reproduction or republication is strictly prohibited without the prior written permission from the American Dental Association.

5/26/2010

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