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Dental Abstracts

Volume 62, Issue 2, March–April 2017, Page 101
Dental Abstracts

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Periodontal therapy, HbA1c, and glycemic control

https://doi.org/10.1016/j.denabs.2016.07.056Get rights and content

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Background

Several investigations have linked periodontal disease (PD) with hyperglycemia. Inflammation from the PD increases the circulation of proinflammatory cytokines, which can then impair insulin action, contribute to insulin resistance, and result in hyperglycemia. Undergoing periodontal therapy can resolve the inflammation, reduce circulating cytokine levels, and reduce hyperglycemia in patients with diabetes. Periodontal treatment in diabetics has been shown to reduce hemoglobin A1c (HbA1c)

Methods

The study cohort consisted of 126,805 persons with diabetes and PD. They ranged in age from 21 to 107 years (average 64 years) and had diabetes for a mean of 4 years. Follow-up lasted an average of 1.7 years. To manage confounding characteristics, a marginal structural model (MSM) was used for analysis. Care was delivered between 2005 and 2012, with changes in periodontal status between baseline and follow-up measured. The specific outcomes were change in HbA1c after initial treatment and

Results

The mean HbA1c increased from 7.03% to 7.21% in all participants. A periodontal maintenance visit was attended by 29.4% of the subjects within 6 months of the baseline visit. Periodontal treatment at baseline reduced HbA1c by −0.02%; at follow-up periodontal treatment lowered the HbA1c by −0.074%. Treatment at follow-up increased the likelihood of individuals who achieved diabetes control by 5% at the HbA1c threshold of <7% and by 3% at the threshold of <9%.

The effects of the initial

Discussion

The reduction in HbA1c level after long-term periodontal treatment was clinically meaningful in persons whose baseline level was 9% or greater and modest in all other patients. Long-term periodontal treatment increased the likelihood that glycemic control would be achieved and improved glycemic control across all BMI levels, even among never smokers.

Clinical Significance

Patients with type 2 diabetes may benefit in a clinically meaningful way by taking care of their periodontal health needs.

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Merchant AT, Georgantopoulos P, Howe CJ, et al: Effect of long-term periodontal care on hemoglobin A1c in Type 2 diabetes. J Dent Res 95:408-415, 2016

Reprints available from AT Merchant, Dept of Epidemiology and Biostatistics, Arnold School of Public Health, Univ of South Carolina, 915 Greene St, Columbia, SC 29208; e-mail: [email protected]

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