Treating gum disease: can it help diabetics control their blood sugar levels?

iStock_000013589042_SmallGum disease treatment is used to reduce swelling and infection from gum disease. Keeping blood sugar levels under control is a key issue for people with diabetes, and some clinical research suggests a relationship exists between gum disease treatment and glycaemic control. As a result, it is important to discover if gum disease treatment does improve glycaemic control to encourage better use of clinical resources.

There is a broad range of gum disease treatments available for treating patients with diabetes. This review considered:

1. Does gum disease treatment improve blood sugar control in people with diabetes?
2. Does one type of gum disease treatment have a bigger effect than another in improving blood sugar control?

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New Oral Health Group Podcast

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c Liam Dunn, published under Creative Commons licence

Did you know? There are now a range of Cochrane podcasts available on the Cochrane Library.

The latest Oral Health Group podcast is by the University of Manchester’s Lucy O’Malley, who gives the lowdown on her review: Primary school interventions for preventing caries. Follow the link to listen in and hear the findings!

Other available Oral Health Group podcasts include:

Follow the links to read the Cochrane Summary, and then click “Podcast” on the bottom right of the page to listen.

Controlling gum disease may help to control diabetes, but more research is needed

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Periodontal scaler

This week is National Diabetes Week. Did you know that looking after your gums may help to reduce your blood sugar levels if you are diabetic? Read more about our Review of the Month for June.

What was the research?

A systematic review of the evidence to find out whether treating gum disease in people with diabetes helps to lower blood sugar levels. The review looked at several different types of intervention to treat periodontal disease in diabetic patients.

They included:

  • Scaling (cleaning between the gums and teeth)
  • Subgingival curettage and gingivectomy (removal of inflamed or diseased gum tissue)
  • Flap surgery (cleaning the tooth roots and repairing bone damage)
  • Antiseptic mouthrinses, gels and toothpastes
  • Treatment with drugs such as antibiotics
  • Training people in oral hygiene measures.

Who conducted the research?

The research was conducted by a team led by Terry C. Simpson from Edinburgh Dental Institute in the UK, on behalf of the Cochrane Oral Health Group. Ian Needleman, Sarah H. Wild, David R. Moles and Edward J. Mills were also on the team.

What evidence was included in the review?

Data was extracted from 7 randomised controlled trials. The trials looks at the intervention compared to no intervention, placebo or “usual care”. 460 participants were included across the 7 trials.

What did the evidence say?

The evidence suggests that there may be small but significant improvements in blood sugar control from treating pre-existing gum disease in people with Type 2 Diabetes Mellitus. There was little data on people with Type 1 Diabetes Mellitus. The studies looked at ultrasonic scaling, antibiotics, root planing, and oral hygiene measures.

How good was the evidence?

Although seven trials met the inclusion criteria, only 3 compared the intervention with no treatment or “usual care”. Only two of the seven trials was at low risk of bias. The few studies available lacked the power to detect a significant effect, and the quality of the evidence was generally low.

What are the implications for dentists and the general public?

Periodontal therapy in individuals with diabetes might help to improve the management of their condition, and an oral health assessment should be recommended as part of routine care for diabetes. If diagnosed, trained oral health professionals should manage the periodontitis. Communication between professionals is important so that patients become aware of the importance of periodontal disease management to controlling blood sugar levels.

What should researchers look at in the future?

Both periodontal disease and diabetes are prevalent, and further studies examining the link between the two should be a public health priority. More larger scale randomized controlled trials are necessary, as the studies in this review were too small to show a significant effect.

Link

Simpson TC, Needleman I, Wild SH, Moles DR, Mills EJ. Treatment of periodontal disease for glycaemic control in people with diabetes. Cochrane Database of Systematic Reviews 2010, Issue 5. Art. No.: CD004714. DOI: 10.1002/14651858.CD004714.pub2.