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The treatment of chronic inflammation of the gums could help people with diabetes to control their disease, according to a recent study.
The 264 participants in the study all had type 2 diabetes and periodontitis, a chronic bacterial infection of the gums that causes persistent inflammation and is a major cause of adult tooth loss.
"Although further research is needed to explore the exact mechanisms" by which the treatment of gum disease can help diabetics, "a reduction in systemic inflammation (…) is the most plausible link" , said the head of the study, Francesco D'Aiuto.
Over the course of a year, patients undergoing intensive periodontal treatment by dentists have seen improvements not only in their blood glucose levels, but also in the health of their kidneys and blood vessels.
The researchers write in The Lancet Diabetes & Endocrinology, type 2 diabetes, linked to obesity and lack of physical activity, is a leading cause of disability and premature death, mainly as a result of vascular and renal complications. Periodontitis often coexists with diabetes.
Half of the patients in the study were randomized to receive intensive treatment for their gum disease. The remaining patients did not receive this treatment, but if their gum disease worsened during the year, they quickly received specialized care and were removed from the study. .
In the intensive treatment group, patients had an initial session of scaling the entire mouth. Two months later, patients with good oral hygiene and particularly severe gum disease were treated with periodontal surgery. Patients with poor oral hygiene or severe gum disease at two months continued to experience regular desquamation of root surfaces until the end of the study.
The researchers estimated the average blood sugar by measuring HbA1c, a protein found in red blood cells that indicates blood sugar over a period of two to three months. In case of diabetes, maintaining the HbA1c test results below 7% is generally considered a good control of blood glucose.
At first, the average HbA1c level was 8.1% in both groups. After 12 months, the HbA1c level was on average 0.6% lower in the group receiving intensive treatment for gum disease.
Two markers of kidney health have also improved in the intensive treatment group: blood levels of a substance called creatinine and the amount of blood that passes through kidney filters called glomeruli.
A marker of artery health called flow-induced dilatation has also improved in this group.
Not surprisingly, oral health was also better in the intensive treatment group.
The authors admit that the results could be attributed in part to the effects of the drugs that patients were taking. Nevertheless, they suggest, improving oral health in this population could represent an important therapeutic opportunity.
"Hopefully, follow-up of these patients will continue or more long-term studies will be conducted – to confirm the beneficial effects of intensive treatment of periodontitis in people with diabetes," said Pirkko Pussinen of University of Helsinki. editorial published with the study.
SOURCE: http://bit.ly/2TKJAww The Lancet Diabetes & Endocrinology, online 24 October 2018.
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