Diabetes and Dental Disease
Bidirectional relationshipn C e f o r and periodontitis e v i D e between DM P r a C t i C e
Bidirectional relationship between diabetes mellitus and periodontal disease: State of the evidence linda d. Boyd*, rDH, rD, edD; lori giblin∆ , rDH, ba; dianne Chadbourne¤, rDH, MDH
ABSTRACT
objective: the purpose of this review was to examine existing literature for evidence supporting the bidirectional relationship between diabetes mellitus (DM) and periodontal disease. Method: a search research related to DM and periodontal disease was conducted through PubMed, CinaHl and CCrCt. search terms included: periodontal disease, periodontitis, diabetes mellitus, glycemic control, hemoglobin a1c, glycated hemoglobin, and Hba1c. the search was limited to randomized controlled trials, meta analyses and systematic reviews (sr). results and discussion: literature suggests those with type 2 DM (t2DM) appear to have a 2.6 to 4 times greater risk for more severe periodontal disease than those without DM. Meta analyses also report statistically significant differences in clinical attachment level (Cal) from ≈0.612 to 1 mm for persons with t2DM compared to those without diabetes. the mean difference in hemoglobin a1c (Hba1c) in the literature following periodontal treatment appears to be approximately -0.40%. Major limitations to the existing research is failure to control for confounding factors impacting Hba1c. Conclusion: Despite the potential impact of confounding factors on research findings, it seems clear periodontal disease is more severe in those with diabetes, and that there are small, statistically significant improvements in gylcemic control with non surgical periodontal therapy (nsPt). Dental professionals need to advise individuals with DM to prevent and manage inflammation in the oral cavity to promote overall health. well controlled research on the bidirectional relationship is essential to identify unequivocally the factors linking these conditions.
RESUMÉ
Bidirectional relationship between diabetes mellitus and periodontal disease: State of the evidence linda d. Boyd*, rDH, rD, edD; lori giblin∆ , rDH, ba; dianne Chadbourne¤, rDH, MDH
ABSTRACT
objective: the purpose of this review was to examine existing literature for evidence supporting the bidirectional relationship between diabetes mellitus (DM) and periodontal disease. Method: a search research related to DM and periodontal disease was conducted through PubMed, CinaHl and CCrCt. search terms included: periodontal disease, periodontitis, diabetes mellitus, glycemic control, hemoglobin a1c, glycated hemoglobin, and Hba1c. the search was limited to randomized controlled trials, meta analyses and systematic reviews (sr). results and discussion: literature suggests those with type 2 DM (t2DM) appear to have a 2.6 to 4 times greater risk for more severe periodontal disease than those without DM. Meta analyses also report statistically significant differences in clinical attachment level (Cal) from ≈0.612 to 1 mm for persons with t2DM compared to those without diabetes. the mean difference in hemoglobin a1c (Hba1c) in the literature following periodontal treatment appears to be approximately -0.40%. Major limitations to the existing research is failure to control for confounding factors impacting Hba1c. Conclusion: Despite the potential impact of confounding factors on research findings, it seems clear periodontal disease is more severe in those with diabetes, and that there are small, statistically significant improvements in gylcemic control with non surgical periodontal therapy (nsPt). Dental professionals need to advise individuals with DM to prevent and manage inflammation in the oral cavity to promote overall health. well controlled research on the bidirectional relationship is essential to identify unequivocally the factors linking these conditions.
RESUMÉ