Love and marriage. Peanut butter and jelly. Gum disease and diabetes.
Really and truly. Almost 90% of people with diabetes have gum disease, and more than half of those cases are severe. And the relationship cuts both ways. As a recent review summed it up,
Diabetes mellitus has a detrimental effect on periodontal disease, increasing its prevalence, extent, and severity. In turn, periodontitis negatively affects glycemic control and the course of diabetes.
The good news is that periodontal treatment may improve glucose control, as highlighted in an excellent review and meta-analysis in the Journal of Applied Oral Science.
After searching two major databases of medical research, the research team identified 9 randomized clinical trials focused on the impact of periodontal therapy on glycemic control and inflammation in patients with type 2 diabetes. Analysis showed that both HbA1c and C-reactive protein levels dropped significantly in patients who had their gum disease treated. (C-reactive protein is a common measure of inflammation, a symptom that links gum disease with a wide variety of systemic health conditions.)
The present systematic review with its two meta-analyses indicates that conventional periodontal treatment can improve metabolic control and reduce systemic inflammation in patients with [type 2 diabetes] by reducing serum levels of HbA1c and CRP, respectively. The results of the metabolic control achieved by treatment and the reduction of systemic inflammation are consistent with the results of other systematic reviews and meta-analyses.
There’s another way we can look at the impact of periodontal treatment on diabetes, though: healthcare costs. And that brings us to a brand new study in the Journal of the American Dental Association (JADA).
The study analyzed data from IBM MarketScan commercial insurance and Medicaid databases to examine the relationship between periodontal treatment and overall healthcare costs per patient. The results were attention-grabbing:
- Healthcare costs were 12% less for periodontal patients with private insurance – a difference of almost $2000.
- Healthcare costs were 14% for periodontal patients with Medicaid – a difference of over $2300.
“Undergoing periodontal treatment,” the authors wrote in their conclusion,
was associated with significant reductions in overall health care costs for patients with DM [diabetes mellitus] in both Medicaid and commercial insurance claims data, with a larger difference seen for Medicaid enrollees…. A healthy mouth can play a key role in a DM management program.
It can, indeed.