Peridontal Disease and Diabetes
This week we are going to explore a view of this two-way street from the other direction; how systemic issues and possibly disease may present themselves in our mouths!
I believe that this topic will become increasingly important in the future as we search for ways to curb spiraling health care costs through early prevention. This will involve new tests using blood and/or saliva that may be done by dental professionals that will detect biomarkers of certain conditions as well as determining visual clues that might also be present in the mouth. Truly, this is where dentistry and medicine will increasingly work together as we move toward treating the “whole” client.
Science now believes that inflammation is a precursor to degenerative disease and therefore if present, may be an indicator that we need to pay attention to. As a practicing dental hygienist, I can tell you that in working with clients over the years from both a clinical and homecare perspective, quite often we are not able to get resolution of oral inflammation and this can be due to a known condition that the client has.
Let’s take a look at diabetes, where clients are more susceptible to infection – any infection – including periodontal disease and there is also evidence that people with diabetes have more periodontal disease. Studies done by periodontists for at least 50 years have shown that the more poorly controlled the diabetes, the more severe the periodontal disease. In a study done with the Pima Indians many years ago, they found that when periodontal health improved through clinical intervention and homecare, so did their diabetes. In an article written by Dr’s Loe and Genco on the oral complications of diabetes, they also point out that the disease may initially manifest with oral symptoms other than thirst such as: mucosal abnormalities, such as erosive lichen planus, burning tongue and gingival bleeding, most of which resolved with treatment directed at improving glycemic control.
There is now a test being done in some dental offices in the United States that can be administered easily and can help determine if a client has a pre-diabetic condition. HbA1c is a test that measures the amount of glycated hemoglobin in your blood. Glycated hemoglobin is a substance in red blood cells that is formed when blood sugar (glucose) attaches to hemoglobin. Basically, this test measures what your average blood glucose level (bg) has been for the last few months. There’s some debate as to how far back in time it goes, but it’s about 2 or 3 months, with a bit more emphasis on the most recent month. But even without this test, many Dental Hygienists are in a perfect position to be able to pick-up on clinical and visual changes within their clients mouths such as unusual bleeding and/or excessive plaque formation which may also signal a change in their blood glucose and the need to then refer to their physician.
Remember if you are diabetic, improving your oral health can help improve your diabetes; talk to your dental professional.
Do these findings surprise you? I’d love to get your feedback. Here on my blog, you’ll get commentluv. That’s a plug in that enables you to provide a link back to your own site. I look forward to hearing from you.
Until next time,