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How healthy are your diabetic patients' mouths?

Health begins in the mouth

Periodontitis is recognized as the "sixth diabetes complication" - after retinopathy, nephropathy, neuropathy, macroangiopathy and delayed wound healing. The prevalence, severity and progression of periodontitis are associated with diabetes mellitus. The connection is bidirectional, i.e. the presence of diabetes mellitus favors the development and progression of periodontitis. On the other hand, periodontitis can also have an influence on diabetes.

Numerous international studies have shown links between periodontal disease and

  • Type I diabetes (also in children)
  • Type II diabetes
  • Gestational diabetes
  • Lipometabolic disorders and obesity
  • Diabetes-associated complications, such as retinopathy, neuropathy, proteinuria, nephropathy and cardiovascular concomitant diseases
Possible complications

Is there a need for action?

Yes, on the one hand for your diabetes patients, because ...

  • diabetics have an approximately 3-fold increased risk of developing periodontitis compared to non-diabetics
  • manifest periodontitis increases the insulin resistance of the tissues and thus makes it more difficult to control blood sugar levels
  • the HbA1c value rises as the severity of periodontitis increases.
  • the risk of diabetes-associated complications is increased by periodontitis

On the other hand, for non-diabetics or those with impaired glucose tolerance, because …

  • the risk of developing prediabetes as a result of (possibly undetected) periodontal disease is significantly increased
  • Periodontitis is associated with increased triglyceride and LDL cholesterol levels
  • Periodontitis increases the risk of cardiovascular disease
aMMP-8

Expanding diagnostics with aMMP-8

A recent systematic Cochrane analysis found that in type 1 and 2 diabetes, treatment of periodontitis can lead to improved blood glucose control and a significant reduction in HbA1c.
As a check-up to identify patients at risk of periodontitis, PerioSafe DR is an addition to the internal medicine practice prevention program.

With PerioSafe 

Advanced diagnostics with PerioSafe

  • With PerioSafe DR, clinicians can detect active oral collagen degradation at a reversible stage, i.e. before the gums appear clinically conspicuous
  • PerioSafe DR is particularly suitable for patients with type 1 and 2 diabetes and an increased risk of diabetes
  • PerioSafe DR is easy to use chairside in the internal medicine practice (saliva sample)

Oral health is particularly important for:

  • Type 1 and type 2 diabetics
  • Obese patients
  • Patients with metabolic syndrome
  • Patients with cardiovascular risks
  • All patients who want to do more for their (oral) health as a preventive measure

What to do if the value is high?

In the event of a finding, a referral to a periodontist or specialist dentist for periodontology is advisable as part of an interdisciplinary collaboration. Patients should be informed about the risks of a possibly incipient or manifest chronic periodontal inflammation in connection with their individual health situation.

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Dirk-Rolf Gieselmann

Dirk-Rolf Gieselmann

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