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VA RESEARCH QUARTERLY UPDATE
This Issue: Chronic Disease Care | Table of Contents: Spring 2017 | Download this issue

Noteworthy Publications

Better dental care improves health for Vets with type 2 diabetes


Regular periodontal dental cleanings can help control type 2 diabetes, according to studies.
<em>(Photo: ©iStock/yoh4nn)</em>
Regular periodontal dental cleanings can help control type 2 diabetes, according to studies. (Photo for illustrative purposes only. ©iStock/yoh4nn)

Regular periodontal dental cleanings can help control type 2 diabetes, according to studies. (Photo for illustrative purposes only. ©iStock/yoh4nn)

A team including researchers at the Wm. Jennings Bryan Dorn VA Medical Center in Columbia, South Carolina, and Michael E. DeBakey VA Medical Center in Houston found that Veterans who had type 2 diabetes and periodontal disease achieved better control of their blood sugar levels when they received regular periodontal dental cleanings. The study results were published in the April 2016 issue of the Journal of Dental Research.

Researchers prospectively tracked the electronic medical records of 126,805 Veterans who had type 2 diabetes and periodontal disease and who had received health care services at a VA facility from 2005 to 2012. Their aim was to evaluate the effects of long-term dental cleanings on glycemic control in Veterans with type 2 diabetes by measuring hemoglobin A1C blood levels (a measure of disease control).

At baseline, study participants were 64 years old on average and had several diabetes risk factors. Sixty percent had hemoglobin A1C blood levels under 7 percent—where a normal range is between 4 and 5.6 percent. Fifty-eight percent were obese, and 12 percent were taking insulin to control their diabetes. They had been living with the disease for an average of four years.

The researchers found that the greatest treatment benefit came to Veterans who received regular, long-term dental cleanings. While smoking did not affect reductions in hemoglobin A1C after initial periodontal treatment, obese patients received less benefit from initial treatment. Those patients who had baseline hemoglobin A1C levels below 9 percent experienced the greatest reductions in blood sugar levels after long-term follow up (average 1.7 years) with dental cleanings. However, all study participants did experience modest improvement in hemoglobin A1C with long-term dental care.

Periodontal disease has been shown to be associated with elevated blood sugar. The disease causes inflammation that can increase the release of pro-inflammatory cytokines. These small proteins are produced by the immune system and can reduce the effectiveness of the body's naturally produced insulin. When the body becomes resistant to insulin, it is unable to properly metabolize sugar in the bloodstream, causing damage to internal organs.

Because periodontal disease causes inflammation in the mouth and other parts of the body it can elevate blood sugar levels, making it harder for patients with diabetes to control their disease. Researchers in this study recommend that patients with diabetes and periodontal disease get long-term periodontal dental care to help improve their overall health.


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