Can Treating Gum Disease Improve Blood Sugar Control?

Dr. Ellie-Kheirkhahi-Love DDS, MSD

It's long been known that diabetes can lead to gum disease — one of a long list of possible complications. But can treating gum disease improve blood sugar control?

Dentists say there's some evidence to think so. And now San Antonio and three other cities are taking part in a large, federally funded study to find out.

A number of small and observational studies over the years have appeared to show that treating gum disease improves blood sugar in diabetes. But it's far from proven, said Dr. Thomas Oates, assistant dental dean for clinical research at the University of Texas Health & Science Center.

“We're saying OK, if gum disease is contributing to poor glycemic control in these patients, if we treat the patients' gum disease will it reverse that process and improve it? And that's what our study is really looking to do,” Oates said.

The study will enroll 600 adults — about 150 from San Antonio — who are 35 and older with both diabetes and gum disease.

While gum disease is an infection, it also causes inflammation, which has been linked to greater insulin resistance and poor blood sugar control. It also can cause pain and tooth loss, which can interfere with healthy eating, researchers said.

“We expect a modest effect — certainly not a cure for anything,” said Dr. Steven Engebretson, assistant professor of periodontics at Stoneybrook University, N.Y., who is heading the study. “We can't even cure periodontal disease. But even if it's a modest improvement for these patients, I think they'll take it. Because we know that Type 2 diabetes is relentless and it is progressive.”

Good dental care is one of many health care recommendations given to new diabetes patients, along with regular eye and foot exams, self-monitoring of blood sugar, a healthy diet and exercise. Diabetics have a harder time fighting off infection, which leads to more plaque buildup and slower healing.

There are other connections between the two conditions. Engebretson noted that the poor are more prone to developing both diabetes and gum disease, and that the problem is aggravated by the fact they often lack dental insurance and can't afford regular care.

“We're finding that the patients who enroll in our study who might be helped are struggling with their diabetes and often have had no access to periodontal treatment, just because the cost of dentistry is high,” Engebretson said.

And while surgical treatment for gum disease can run thousands of dollars in a specialist's office, the treatment offered in the study is the basic kind — scaling and root planing, sometimes called deep cleaning — that can be done in a general dentist's office.

“It's a fairly basic level of care for gum disease,” Oates said. “Then we're going to follow up and see if that now has an effect in improving the blood sugar levels.”  www.drellielove.com