Dental Hygienist with Type II Diabetes
By: Jan Lazarus RDH
January 17, 2018
Knowing the scientific information that clearly confirms the bi-directional relationship with diabetes and periodontal disease, our goal is reduce the periodontal pathogens to improve the diabetic status.
- Age: 38
- Sex: F
- Medical History: Recently diagnosed with Type II Diabetes. See Nutrition Notes.
- Family History: Type II Diabetes & Periodontal Disease
- Last Dental Exam: 8 weeks ago
- Home Care: Meticulous consisting of electric toothbrush 2x/day, flossing daily and water piking 1x/d
- Nutrition Notes: Her physician agreed to her commitment to diet and lifestyle changes before considering medication to control her Diabetes. These changes included regular exercise and eliminating sugar.
- Chief Complaint: “When it comes to my diabetes, I know what to do, I just have to do it!” Also the patient is a dental hygienist, she wants to know she is doing everything possible orally.
- Periodontal Assessment: No bleeding on probing, scattered 4mm posterior areas of 1 mm recession, no visible inflammation and excellent plaque control. Grayish tissue color (most likely due to lack of circulation) w/ lack of stippling around crowns. Residual light calculus around crown margins. Radiographic evidence of posterior bone loss.
- Performed initial MyPerioPath® on 9/10/2015
- Periodontal therapy: Removal of residual marginal calculus around crowns and complete biofilm disruption with ultrasonic slim line inserts, hand scaling with curettes and subgingival airpolish conducted in two appointments
- No systemic antibiotics were administered due to patient wanting to see what her body could do first.
- Lifestyle & Diet changes
- Home Care: Remained the same
- Performed follow up MyPerioPath® post therapy 3/10/2016
- Would she have gotten the same great reduction in pathogens if she had not changed her diet and lifestyle?
- Did the pathogens contribute to her diabetes or did the
imbalance of blood sugar contribute to the proliferation of pathogens?
The periodontal changes were favorable; the color and texture of tissue presented healthy and the 4 mm pockets reduced to 3mm. The MyPerioPath® post-therapy results (MyPerioProgress®) showed a dramatic shift in the bacterial load. More importantly, when the patient presented to her medical doctor to evaluate her diabetic control, she had reversed her diagnosis. Her lab tests confirmed a normal A1C and blood glucose levels.
This patient is most grateful that she had the opportunity to test for periodontal pathogens and had a relatively simple treatment to eliminate the pathogens and positively influence her diabetic diagnosis! This case highlights the role of dental care with overall health, the need to comanage patients and the need for patient cooperation.
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