Diabetes
Diabetes
Diabetes is a well-established and significant risk factor for the development and progression of periodontitis. In addition, periodontal disease can worsen diabetes control (see Control of diabetes).
The dental team have a role to play in both the detection of undiagnosed diabetes and providing dental treatment and support to patients with diabetes. Furthermore, the control of oral inflammation (including periodontitis) has been shown to improve diabetes control.
If your patient has diabetes:
Ask
Ask about the patient’s degree of diabetes control:
- Ask about their most recent HbA1C result; unstable glycaemic control typically has HbA1c levels above 7% or 53 mmol/mol.
- Ask about complications of diabetes, such as cardiovascular disease, kidney disease, problems with the eyes and feet, episodes of hypoglycaemia.
- Ask about the frequency of their diabetes reviews; this may give an indication of their level of diabetes control.
- Ask if they have noticed any problems with their mouth (e.g. bleeding gums, dry mouth).
- If the patient is not registered with you (e.g. is attending on an emergency basis), ask if they have a general dentist.
Advise
Advise the patient that:
- periodontal disease affects the gums, bone and other supporting tissues of the teeth and is caused by the bacteria in dental plaque biofilm
- people with diabetes are at higher risk of periodontal disease
- poor periodontal health and inflammation can make diabetes worse
- controlling periodontal inflammation can help with control of diabetes
- a dentist or hygienist/therapist can help by providing periodontal treatment
Act
Offer treatment and support to the patient, including providing oral hygiene instruction, periodontal treatment, if required, and increased frequency of review.
- Information for patients is available (see Patient information)
If the patient has signs of poorly controlled diabetes (i.e. periodontal problems), ask them to discuss this with their medical team. Alternatively, a template letter that can be used to contact a patient’s General Medical Practitioner is available.
If the patient is attending on an emergency basis, signpost them to where they can access follow-up treatment with a general dental practitioner and their own medical team.