By: Wanda Nazario, Dentist
MCS Administrative Director of Dental Services

These days, we have studies that reveal the close and important relationship between diabetes and oral health. . We’ve all learned from a young age how important it is to brush our teeth twice a day and avoid eating sweets. We might even think these prevention tips are a simple and easy formula to enjoy a healthy life.

However, despite progress in scientific knowledge on health issues, the number of adults facing chronic conditions such as periodontal disease and diabetes continues to rise. Multiple factors, including genetics and lifestyles, are the same root causes for both conditions.

Studies such as those by Dr. Casanova and others¹ have established these conditions as bidirectional, with diabetes increasing the risk of periodontitis, which in turn affects a patient’s glycemic control. This bidirectional relationship has been the topic of extensive literature that strives to raise awareness among all parties concerning the direct impact that each condition has on the other.2 ²

• For example, the treatment of periodontal conditions, as reported, leads to an HbA1c reduction of approximately 0.4%. This is similar to the progress that can be expected with changes in pharmaceutical management, by adding a second drug for a patient who has difficulty controlling hyperglycemia, but at a lower cost to the patient, and without permanent side effects.
• Another important interaction is the maintenance of one’s teeth. If the patient does not have teeth, his or her diet is limited, nutrition is altered, and this could lead to poor control of glucose or blood sugar.

Prevention and treatment of oral conditions has become one of the important tools for managing diabetes. Likewise, to achieve optimal health in diabetes patients, interdisciplinary management of these conditions becomes a necessity. That’s why, in its 2021 standards of care, the American Diabetes Association states that a referral to the dentist should be part of initial medical care management.3 Effective treatment of oral health conditions in patients with diabetes includes management, not only for periodontitis, but also dry mouth, candidiasis, cavities and tooth loss, among others.
These conditions affect the patient’s quality of life significantly. When detecting complications of an oral nature, doctors must be able to guide the patient on the importance of maintaining hygiene habits and visiting the dentist for proper management. In turn, by detecting advanced periodontal conditions, dentists can help identify prediabetic patients or those who are unaware of their diabetes condition, referring them to their doctor for evaluation.

Although a multidisciplinary team is essential to properly manage this chronic condition, people with diabetes also play a leading role in achieving a better quality of life. This is done by:

Controlling sugar intake. This healthy habit not only helps the glycemic index, but prevents cavities.

Maintaining oral hygiene on a daily basis. This helps fight periodontal disease.

Recognizing signs of poor oral health. Oral changes such as bleeding gums, dry mouth and changes in taste can help identify problems with diabetes control.

Making prevention appointments: communication among the various healthcare professionals is achieved.

Sometimes, caring for one’s teeth and gums takes a back seat when talking about diabetes and its complications. Let’s visit the dentist as recommended in order to comply with routine procedures and achieve Complete Health.

References:

1. Casanova L. Hughes FJ. Preshaw PM. Diabetes and periodontal disease: a two-way relationship. British Dental Journal 2014; 217(8): 433-7.
2. Borgnakke WS and Poudel P (2021)- Diabetes and oral health: summary of current scientific evidence for why transdisciplinary collaboration is needed. Frontiers in Dental Medicine. 2:709831.2021
3. American Diabetes Association, Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Medical Care in Diabetes – 2021. Diabetes Care 2021: 44(S1): S40.S52