Impact of periodontal treatment on diabetes management

Background + Aims

• Periodontitis and type 2 diabetes mellitus (T2DM) often occur together. Periodontitis is a severe gum disease that causes inflammation and tissue damage.
• Diabetes increases the risk of periodontitis due to poor wound healing and immune response.
• Poor glycaemic management in individuals with diabetes worsens periodontitis, while severe periodontitis can raise blood glucose levels, creating a harmful cycle.
• Non-surgical periodontal treatment, including deep cleaning and maintaining good oral hygiene, may improve both oral health and blood glucose management.
• The study aimed to explore if 6-months of non-surgical periodontal treatment could reduce glycated haemoglobin (HbA1c) levels in people with type 2 diabetes and chronic periodontitis.

Materials + Methods

• This was a 6-month single-blind, randomised controlled trial involving 90 participants with type 2 diabetes and generalised chronic periodontitis.
• Participants were divided into two groups:
  • Treatment Group (TG): Received scaling and root planing (deep cleaning) alongside oral hygiene instructions.
  • Control Group (CG): Received basic oral hygiene instructions and supragingival cleaning (cleaning above the gum line).
• HbA1c levels, fasting plasma glucose, gingival health (plaque index, gingival index, probing pocket depth (PPD)), and bacterial presence were assessed at baseline, 3- and 6-months.
• Outcomes assessed:
  • Primary – Change in HbA1c levels
  • Secondary – Changes in periodontal health parameters and bacterial analysis.
• Data were statistically analysed to assess the significance of changes.

Results

• Non-surgical periodontal treatment significantly improved HbA1c levels in the treatment group:
  • HbA1c reduced by 0.47% in the TG compared to no significant change in the CG.
• Periodontal parameters, including reduced PPD and plaque index, improved significantly in the TG but not in the CG.
• Fasting plasma glucose levels decreased in the TG and increased in the CG, showing a significant difference between the groups.
• The bacterial analysis showed varied responses, with reductions in some bacterial species linked to periodontitis in the TG.
• No major adverse effects were reported in either group.

Limitations