Dr. McGlennen: Many resources confirm a bi-directional relationship between periodontal disease and Type II diabetes; which in simple terms means if you have one, you will most likely have the other. Elevated levels of periodontal bacteria can directly cause hyperglycemia.1 Long term, the inflammation associated with increased pathogen burden can affect the health of the pancreas. Specifically, there is the risk of the loss of beta cells that produce insulin and respond to elevated blood glucose.2 Conversely, persons with elevated blood glucose are at risk for heightened levels of oral bacteria and hence, for progressive periodontal infections and inflammation.3 So, by these opposing mechanisms, the relationship of periodontal disease, pre-diabetes and diabetes is viewed as a two-way street.4 Early detection of periodontal infections and proactive management to reduce bacterial loads can improve one’s control of blood sugar and lessen the associated complications of diabetes, as well as the consequence of periodontitis.5
Many dental and medical practitioners are incorporating an overall health approach. We have invited one of those teams, Washington Center for Dentistry, to share how they present to a patient, communicating the link between periodontal pathogens and Type II Diabetes.
Oral Health Care Provider to Patient: “The problem is you have an active infection. I want to make sure you understand the consequence of not treating this infection is that it will continue to progress and get worse. What I would like to go over with you today is how we can treat the infection with a non-surgical solution.
It will take me two hours and you will be my only patient at that time so that I can specifically treat you and make sure we have all the time we need to get the infection out. I want to make sure you understand that your mouth is connected to your body. The bacteria in your mouth can travel through the bloodstream and affect other areas such as your blood sugar control. So, where I would like to start today is with a simple saliva test to find out specifically which bacteria are causing your infection, and how aggressive the infection is. This way we are not guessing on your treatment, and we can treat you right the first time.”
Professional Comment from Libby:
As an advocate for my patient’s overall health, I discuss how bleeding is a sign of an active infection, and how bacteria in the mouth can travel through the bloodstream and have a specific effect on their Metabolic Health.
Instead of continuing to lecture patients on brushing and flossing better, I recommend they take a simple saliva test, offered by OralDNA® Labs, which tells us what specific bacteria are causing the infection, and how aggressive the infection is. This allows us to customize their therapy and eliminate bacteria that are resistant to traditional scaling.
- Stanko P, Izakovicova Holla L. Bidirectional association between diabetes mellitus and inflammatory periodontal disease. A review. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2014;158:35-8.
- Janket SJ, Javaheri H, Ackerson LK, Ayilavarapu S, Meurman JH. Oral Infections, Metabolic Inflammation, Genetics, and Cardiometabolic Diseases. J Dent Res 2015.
- Kumar M, Mishra L, Mohanty R, Nayak R. “Diabetes and gum disease: the diabolic duo”. Diabetes Metab Syndr 2014;8:255-8.
- Chee B, Park B, Bartold PM. Periodontitis and type II diabetes: a two-way relationship. Int J Evid Based Healthc 2013;11:317-29.
- Kaye EK, Chen N, Cabral HJ, Vokonas P, Garcia RI. Metabolic Syndrome and Periodontal Disease Progression in Men. J Dent Res 2016;95:822-8.
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