Periodontal treatment in patients with diabetes – what do you need to know?
PD Dr. Kristina Bertl, PhD MSc MBA
We recently discussed the links between periodontitis and diabetes mellitus. But what do you need to watch out for when giving periodontal treatment to patients who also have diabetes?
- Successful non-surgical periodontal treatment seems to lead to a slight improvement in blood glucose level (the HbA1c value can fall by approximately 0.3%). So far, this has primarily been proved in the short term. Long-term study data are still lacking.
- Aside from needing to inform our patients about the links between diabetes and periodontitis (see article), we do not need to adapt or change the treatment measures we use during non-surgical therapy in any special way.
- It is therefore also not necessary to prescribe antibiotics to patients with diabetes as standard. As is the case for all patients, antibiotics should only be prescribed in severe cases of periodontitis.
- Patients with diabetes should specifically be told about the importance of long-term care in controlling their periodontitis.
- Grellmann AP, Sfreddo CS, Maier J, Lenzi TL, Zanatta FB. Systemic anti-microbials adjuvant to periodontal therapy in diabetic subjects: a meta-analysis. J Clin Periodontol, 2016, 43:250–260. Ronaldo Lira Junior, Caroline de Moura Martins Santos, Branca Heloisa Oliveira, Ricardo Guimarães Fischer, Ana Paula Pires Santos. Effects on HbA1c in diabetic patients of adjunctive use of systemic antibiotics in nonsurgical periodontal treatment: A systematic review. Journal of Dentistry 2017, 66:1-7. Simpson TC, Weldon JC, Worthington HV, Needleman I, Wild SH, Moles DR, Stevenson B, Furness S, Iheozor-Ejiofor Z. Treatment of periodontal disease for glycaemic control in people with diabetes mellitus. Cochrane Database of Systematic Reviews 2015, Issue 11. Art. No.: CD004714. DOI: 10.1002/14651858.CD004714.pub3.