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Can patients with diabetes be identified in the dental chair?

At your regular dental checkup, you expect your dentist to examine your teeth and gums for signs of developing cavities, gum disease and even oral cancer. But researchers at Columbia University College of Dental Medicine say your dentist could also be at the forefront to identify undiagnosed diabetes or pre-diabetes during a routine dental visit.

Dental researchers recruited about 600 new participants visiting a dental clinic in Manhattan. None of the participants (more than 40 years old if non-Hispanic and white or more than 30 years old if Hispanic or non-white) had previously been told that they had pre-diabetes or diabetes. A total of 535 patients with at least one self-reported risk factor, including a family history of diabetes, hypertension, high cholesterol or overweight/obesity received a periodontal examination and a simple finger stick hemoglobin A1c test. Patients returned at a later date for a fasting plasma glucose test, a test that detects diabetes or pre-diabetes.

Researchers found that two dental factors—the number of missing teeth and the percentage of deep periodontal pockets—was effective in identifying at-risk patients who had undiagnosed diabetes or pre-diabetes.

"Periodontal disease is an early complication of diabetes, and about 70 percent of U.S. adults see a dentist at least once a year," said Dr. Ira Lamster, dean of the Columbia University College of Medicine and senior author of the study.

"Early recognition of diabetes has been the focus of efforts from medical and public health colleagues for years, as early treatment of affected individuals can limit the development of many serious complications," said Dr. Evanthia Lalla, lead researcher for the study. "Our findings provide a simple approach that can easily be used in all dental care settings."

According to the Centers for Disease Control and Prevention, diabetes affected nearly 26 million people, roughly 8.3 percent of the population, in 2010. Yet just under 19 million of those people were diagnosed. Another estimated 7 million people don't realize they the disease—the seventh leading cause of death in the United States and the leading cause of kidney failure, nontraumatic lower-limb amputations and new cases of blindness among adults in the United States. People with diabetes are also at increased risk for heart disease and stroke.

The study was supported by a research grant from Colgate-Palmolive.

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

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