Dental, diabetes link tops the bill at American meet

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Type 2 diabetics who persistently have trouble controlling their blood sugar may benefit from periodontal treatment.

The link between oral health and type 2 diabetes took centre stage at the American Diabetes Association's (ADA) annual meeting, held last month.

A series of studies presented by dentists revealed oral health plays a key role in maintaining glycemic control among diabetics.

George W. Taylor, an associate professor of dentistry at the University of Michigan schools of Dentistry and Public Health, said data showed type 2 diabetics with periodontal disease were more likely to develop worsened glycemic control.

"This puts them at much greater risk of end-stage kidney disease and death," he said. "We believe...periodontal treatment can provide an increment in diabetes control and a reduction in the risk for diabetes complications."

Studies also found intensive periodontitis intervention could significantly lower levels of A1C, an indicator of long-term glucose control.

"The severity of periodontal disease is associated with higher levels of insulin resistance, which is often a precursor of type 2 diabetes, as well as with higher levels of A1C," said Maria E. Ryan, director of clinical research at the Stony Brook University School of Dental Medicine, New York.

Globally, the Middle East has one of the highest prevalence rates of type 2 diabetes. The United Arab Emirates, Saudi Arabia, Kuwait and Bahrain all rank among the top 10 coutries in the world in terms of diabetes incidence.

Delegates at the ADA heard how a 1988-1994 US population data study found periodontal disease put a person at twice the risk of having insulin resistance, when compared to individuals with good gum health.

"We think periodontitis may adversely affect glycemic control, because the pro-inflammatory chemicals produced by the infection - such as IL-1 beta, IL-6 and TNF-alpha - could transfer from the gum tissue into the bloodstream and stimulate cells to become resistant to insulin," Taylor said. "Then insulin resistance prevents cells in the body from removing glucose from the bloodstream for energy production.

Individuals with persistent difficulty in maintaining glycemic control may benefit from periodontal treatment, Ryan suggested. "Physicians might ask patients when they last saw their dentist, whether periodontitis has been diagnosed and whether treatment has been completed.

"A consultation with the dentist may then be appropriate."

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