Treatment of periodontitis for glycaemic control in people with diabetes mellitus.
(Cochrane Database Systematic Review; doi: 10.1002/14651858.CD004714.pub4)
Terry C Simpson, Janet E Clarkson, Helen V Worthington, Laura MacDonald, Jo C Weldon, Ian Needleman, Zipporah Iheozor-Ejiofor, Sarah H Wild, Ambrina Qureshi, Andrew Walker, Veena A Patel, Dwayne Boyers, Joshua Twigg
Periodontitis is gum disease that damages the tissues supporting the teeth. This review asked whether treating it also helps people with diabetes manage their blood glucose.
Researchers brought together 35 clinical trials involving 3,249 people with diabetes and periodontitis. Nearly all the evidence concerned type 2 diabetes. Treatment usually involved professional cleaning below the gumline, compared with no active treatment or usual care.
At three to four months, HbA1c was around 0.43 percentage points lower in the treatment groups. HbA1c is a blood test reflecting average glucose over the previous few months.
This is a modest average improvement, not a guaranteed result for every person.
Gum health also improved.
Benefits were reported at six and twelve months, but the twelve-month estimate came from only one study and was not the same size as the earlier result.
Treating diagnosed gum disease can contribute to diabetes care as well as improving oral health. It is an addition to your diabetes care plan, not a replacement for it.
The review did not establish that treatment prevents complications such as kidney disease or heart attacks.
Evidence about side effects and quality of life was limited, so those outcomes should not be overstated.
Most participants had type 2 diabetes, so the evidence for type 1 diabetes was limited.
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
