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Nonsurgical treatment of periodontitis for diabetics does not improve glycemic control

Date:
December 17, 2013
Source:
The JAMA Network Journals
Summary:
For persons with type 2 diabetes and chronic periodontitis, nonsurgical periodontal treatment did not result in improved glycemic control, according to a study.
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For persons with type 2 diabetes and chronic periodontitis, nonsurgical periodontal treatment did not result in improved glycemic control, according to a study appearing in the December 18 issue of JAMA.

Emerging evidence implicates inflammation in the development of type 2 diabetes. Chronic periodontitis, a destructive inflammatory disorder of the soft and hard tissues supporting the teeth, is a major cause of tooth loss in adults. Nearly half of the U.S. population older than 30 years is estimated to have chronic periodontitis, according to background information in the article. Individuals with diabetes are at greater risk for chronic periodontitis. Well-controlled diabetes is associated with less severe chronic periodontitis and a lower risk for progression of periodontitis, suggesting that level of glycemia is an important mediator of the relationship between diabetes and risk of chronic periodontitis. Limited evidence suggests that periodontal therapy may improve glycemic control.

Steven P. Engebretson, D.M.D., M.S., M.S., of New York University, New York, and colleagues examined whether nonsurgical periodontal therapy, compared with no therapy, reduces levels of glycated hemoglobin (HbAlc) levels in persons with type 2 diabetes and moderate to advanced chronic periodontitis. The trial included 514 participants who were enrolled between November 2009 and March 2012 from diabetes and dental clinics and communities affiliated with 5 academic medical centers. The treatment group (n = 257) received scaling and root planing plus an oral rinse at baseline and supportive periodontal therapy at 3 and 6 months. The control group (n = 257) received no treatment for 6 months.

The researchers found that levels of HbAlc did not change between baseline and the 3-month or 6-month visits in either the treatment or the control group, and the target 6-month reduction of HbAlc level of 0.6 percent or greater was not achieved. There were no differences in HbAlc levels across centers.

Periodontal measures improved in the treatment group compared with the control group at 6 months.

“This multicenter randomized clinical trial of nonsurgical periodontal treatment for participants with type 2 diabetes and chronic periodontitis did not demonstrate a benefit for measures of glycemic control. Although periodontal treatment improved clinical measures of chronic periodontitis in patients with diabetes, the findings do not support the use of nonsurgical periodontal treatment for the purpose of lowering levels of HbAlc,” the authors conclude.


Story Source:

The above post is reprinted from materials provided by The JAMA Network Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Steven P. Engebretson, Leslie G. Hyman, Bryan S. Michalowicz, Elinor R. Schoenfeld, Marie C. Gelato, Wei Hou, Elizabeth R. Seaquist, Michael S. Reddy, Cora E. Lewis, Thomas W. Oates, Devjit Tripathy, James A. Katancik, Philip R. Orlander, David W. Paquette, Naomi Q. Hanson, Michael Y. Tsai. The Effect of Nonsurgical Periodontal Therapy on Hemoglobin A1cLevels in Persons With Type 2 Diabetes and Chronic Periodontitis. JAMA, 2013; 310 (23): 2523 DOI: 10.1001/jama.2013.282431

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The JAMA Network Journals. "Nonsurgical treatment of periodontitis for diabetics does not improve glycemic control." ScienceDaily. ScienceDaily, 17 December 2013. <www.sciencedaily.com/releases/2013/12/131217170958.htm>.
The JAMA Network Journals. (2013, December 17). Nonsurgical treatment of periodontitis for diabetics does not improve glycemic control. ScienceDaily. Retrieved August 28, 2015 from www.sciencedaily.com/releases/2013/12/131217170958.htm
The JAMA Network Journals. "Nonsurgical treatment of periodontitis for diabetics does not improve glycemic control." ScienceDaily. www.sciencedaily.com/releases/2013/12/131217170958.htm (accessed August 28, 2015).

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