Diabetes Awareness Month: Diabetes and Oral Health

According to latest figures from Diabetes Canada, the prevalence of diabetes in Canada is estimated at 3.4 million people, or 9.3% of the population, and this figure is rising. This means that the average general dentist is likely to come across this condition and its associated impact on periodontal health on a weekly basis.

In this short video, Dr. Aditya Patel, periodontist from Halifax, and President-Elect of the Canadian Academy of Periodontology, discusses the relationship between diabetes and periodontal disease and offers advice on how to recognize it in the practice. He also shares some of the latest research on the connection between diabetes and oral health.

Here are some of the key takeaways from the conversation:

CO-RELATIONSHIP BETWEEN DIABETES AND PERIODONTAL DISEASE

• The incidences of both diabetes and periodontal disease are rising. Seven out of 10 Canadians will have some form of periodontal disease in their lifetime.
• Diabetes and periodontitis are co-related, meaning that there is a strong association between the two conditions, although there is no causation. A patient who is diabetic will not necessarily have periodontal disease, but there is an increased risk and an increased prevalence of periodontal disease among diabetics.
• Because of this co-relationship, the two conditions impact each other. Patients with uncontrolled diabetes incur severe attachment loss, which manifests as gingival recession. Other signs include xerostomia and an increased degree of gingivitis due to the possible impact of the local immune system.
• Research studies show that diabetic patients have an increased level of cytokines/inflammatory mediators in the mouth which cause an increased amount of periodontal disease.

DETECTING UNDIAGNOSED DIABETES

• Common signs that may prime the dentist to consider the presence of a systemic condition include:
  • weakness or fatigue
  • excessive thirst
  • shortness of breath
  • xerostomia (without medication)
  • frequency of infections, specifically gingival abscesses (often multiple sites of infection).
  • slow or delayed healing following surgery.
• Thorough periodontal charting is key and can help guide us towards a reduced response from the immune system.

RECENT STUDIES

• Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions, Journal of Periodontology, February 2018.
• Proportion and severity of periodontitis and correlation of periodontal inflamed surface area with glycemic status in patients with type 2 diabetic neuropathy with and without diabetic foot, Journal of Periodontology, August 2021.
• Baseline HbA1c Level Influences the Effect of Periodontal Therapy on Glycemic Control in People with Type 2 Diabetes and Periodontitis: A Systematic Review on Randomized Controlled Trials, Diabetes Therapy, January 2021.
• HbA1c Changes in Patients with Diabetes Following Periodontal Therapy, Journal of Periodontal and Implant Science, March 2021.

We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.

Until next time!
CDA Oasis Team