Uncontrolled Diabetic- Referred by Physician

By: Mary Kay Carroll, RDH

July 18, 2018

The Challenge:

To find the source of her inflammation and infection. If the source is of a bacterial nature, then the goal is to reduce the bacteria. By reducing the bacterial load, the hope is to reduce or eliminate medications for diabetes and blood pressure. Please note: The patient accepts her responsibility for the decline in her overall health.

The Background:

  • Age: 41
  • Sex: Female
  • Medical History: Type II Diabetes, High BP, Acid reflux
  • Family History: Cardiovascular disease, diabetes and cancer
  • Last Dental Exam: 2008
  • Home Care: Manual toothbrush
  • Chief Complaint: “My doctor said my uncontrolled diabetes could be caused by my mouth.”
  • Other Notes: Soda consumption
  • Clinical Assessment: Sub-gingival and supra-gingival calculus present, tissue inflamed and bulbous
  • Periodontal Assessment: Localized chronic, active periodontal disease, slight to moderate

The Solution:

  • Date of MyPerioPath®: 7/27/2017
  • Periodontal therapy: Level 5 Full mouth therapy performed. The “5 tip” cavitron method was incorporated with irrigation of water and chlorhexidine. Arestin® was placed in pockets 5mm or greater
  • SABX used: As indicated by the MyPerioPath® results
  • Home Care: Sonicare®, Waterpik™, Pro-Dental Probiotic and A.O Gel
  • Other Notes: Patient was placed on strict home care routine
  • Perform MyPerioProgress® (post-therapy test): 10/19/2018

The Result:

Post therapy results were exciting for both the patient and myself. A major biofilm shift was noted with the reduction of the bacteria responsible for her inflammation. Reduction of pocket depth, bleeding and inflammation was noted. The patient was able to discontinue use of three diabetic medications, preventing the need for diabetic injections! The patient also stated losing 20 lbs., which has stabilized her blood pressure, and reported a pleasant reduction of acid reflux. My patient was thrilled with the overall results and has noticed a huge difference with the way her mouth looks and feels. Reflecting on this case, it is imperative to have all the information on which bacteria are causing the problem. Having the evidence, allows the clinician to tailor the treatment for each patient in order to target the cause and measure the effectiveness following treatment.

About the Author:

Mary Kay received her Associate of Science in Dental Hygiene from the University of Cincinnati in 2001. She has been providing excellent care in general dentistry for the past 17 years. Her passion to educate patients on Oral Systemic Connections has been fueled with recent training by Dental Hygiene Excellence. Mary Kay is most passionate when educating her patients on periodontal disease, sleep apnea, and the benefits of healthy start for her younger patients. She loves the rewarding results that she shares, seeing medications reduced and overall health improving. Mary Kay is happiest spending weekends outdoors running, hiking, or boating with her husband and three boys. While indoors, she loves to cook healthy meals with her family (but will do pizza & wine night with the girls!) and she gets lost doing medical research. You can always find her starting conversations, making friends, and putting a positive spin on life.