Evidence that periodontal treatment improves diabetes outcomes: a systematic review and meta-analysis
(Journal of Clinical Periodontology; doi: 10.1111/jcpe.12084)
Steven Engebretson, Thomas Kocher
Reducing inflammation in the gums might help blood glucose management as well as oral health. To examine this possibility, researchers combined results from several treatment trials rather than relying on one small study.
The review included nine randomised trials involving 719 people with type 2 diabetes and periodontitis. Participants received periodontal treatment or comparison care. All included trials used non-surgical treatment, and some also used antibiotics or antiseptics. Follow-up lasted three to six months. The main outcome was HbA1c, which reflects average blood glucose over recent months.
The pooled estimate suggested an HbA1c benefit of around 0.36 percentage points with periodontal treatment at three months. Results varied between trials, and only five of the nine individually reported a statistically clear reduction. Gum health also improved. Although some studies using additional treatments reported larger reductions, this does not establish that antibiotics were responsible or that they should be routinely added.
This historical review supports the possibility of a modest glucose benefit from treating periodontitis in people with type 2 diabetes. It does not promise a particular HbA1c reduction for an individual, and the trials could not establish long-term diabetes outcomes. Periodontal treatment should support your overall care, with diabetes medicines and monitoring continuing according to your diabetes team’s advice.
A review can bring together more evidence than one study, but its conclusions still depend on the quality of the research included. Differences in participants, measurements and follow-up can make results difficult to combine. An average finding may not describe every patient, and an uncertain result does not prove there is no effect. This review also reflects the evidence available when its search ended. It should be read as one part of the evidence, with newer research considered before making current treatment decisions.
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Periodontitis is the 6th most prevalent condition globally
Periodontitis and diabetes are bidirectionally linked
Diabetic complications are increased if you have both diseases
Successful periodontal treatment can improve blood glucose control
Periodontitis is the 6th most prevalent condition globally
Periodontitis and diabetes are bidirectionally linked
Diabetic complications are increased if you have both diseases
Successful periodontal treatment can improve blood glucose control
