Single‐blind studies of the effects of improved periodontal health on metabolic control in Type 1 diabetes mellitus

Abstract

Uncontrolled studies have suggested a beneficial effect of periodontal treatment on metabolic control of insulin-dependent diabetes mellitus (IDDM). We therefore conducted controlled single-blind studies, using current metabolic status indicators in IDDM subjects free of significant complications other than periodontal diseases. In the 1st study, 41 IDDM subjects with gingivitis and early periodontitis were randomly assigned to treatment (oral hygiene and scaling) or control groups. The study was completed by 16 experimental and 15 control subjects. Reassessment after 2 months showed a Hawthorne effect in the control group, and no difference between groups. However, further analysis showed a relationship between individual metabolic control variation and gingival inflammation. A 2nd study enrolled 23 IDDM subjects with advanced periodontitis, who were randomised to treatment (full initial therapy including root planning) or control groups. Only 1 subject failed to complete the study, owing to illness. In this study, a significant response to periodontal treatment was not accompanied by any improvement in metabolic control. These results support the concept that the effect of metabolic control may be predominant in the relationship between IDDM and periodontal health.

Obesity and periodontal disease in diabetic pregnant women

“…It has been shown that periodontal infections can change the metabolic-endocrine status of the host, leading to difficulties in the control of blood sugar levels, which can contribute to insulin-resistance, hyperglycemia and complications in the metabolic control of diabetes mellitus 2,11,15 . Moreover, periodontal treatment improves diabetes control 2 . Therefore, periodontal infection control could be one additional important tool used in the metabolic control of gestational diabetes.…”

Systemic Diseases Caused by Oral Infection

“…These findings suggest that severe periodontitis may be an important risk factor in the progression of diabetes, and control of periodontal infection is essential to achieve long-term control of diabetes mellitus. Grossi and Genco (46) reexamined the studies that addressed the effect of periodontal treatment on metabolic control of diabetes mellitus (1,16,47,95,124,132,149). Six of these studies included type 1 patients, and two studies (16,47) included type 2 patients.…”

Does Periodontal Treatment Improve Glycemic Control in Diabetic Patients? A Meta-analysis of Intervention Studies

“…Full texts of these 23 studies were obtained and evaluated. Collectively, we selected 11 intervention studies as final candidates satisfying our inclusion criteria set a priori (Table 1) (Miller et al, 1992;Seppala and Ainamo, 1994;Aldridge et al, 1995;Smith et al, 1996;Westfelt et al, 1996;Grossi et al, 1997;Christgau et al, 1998;Iwamoto et al, 2001;Stewart et al, 2001;Rodrigues et al, 2003). One of these 11 studies (Smith et al, 1996) could not provide a numeric value of HbA1c and was excluded from analyses.…”