Artigos científicos

The diabetic patient with good oral health*

A 51-year old diabetic patient presents with good oral health at a prevention session. Her blood sugar levels are stable at HbA1c = 6.2%, and thus her condition is thought to be sufficiently managed with the antidiabetic drug metformin. The patient has no existing restorations or early oral disease. Using the dental results, it is possible to determine gingivitis in spite of an otherwise stable condition.

© Dr G. Schmalz y Dr D. Ziebolz MSc
Photo: © Dr G. Schmalz y Dr D. Ziebolz MSc
According to Lang & Tonetti

Despite the oral and general health parameters being stable, the patient’s underlying health condition requires her to attend a personalized prevention session. Diabetes mellitus is always associated with an increased risk of periodontitis (12). However, this can be controlled with good medicinal treatment. Regular monitoring of the HbA1c provides information about the course of the blood sugar level over the last eight to twelve weeks, with an HbA1c ≥ 6.5% indicating the presence of diabetes mellitus.


Because diabetes is so closely associated with periodontitis and has a significant impact on its development and progression, careful documentation is essential. Due to its significance, as described above, the patient should be asked for their current HbA1c value at every session.

The links between diabetes mellitus and the risk of periodontitis can be clearly explained during the consultation (12, 15), as can the impacts of a permanently elevated blood sugar level (hyperglycaemia) on the course and progression of periodontitis (16).

Even if the patient’s oral health gives no indication of any particular need for a shorter recall interval, twice-yearly prophylactic sessions are recommended due to the risks that come with diabetes mellitus and its association with an increased risk of periodontitis.

* with the kind permission of Dr G. Schmalz and Dr D. Ziebolz MSc.

Individual Prophy Cycle – The patient-oriented prevention concept

Dr. G. Schmalz
Dr. G. Schmalz

Priv-Doz Dr Gerhard Schmalz is a senior physician at the Oral Health Medicine, Polyclinic for Dental Preservation and Periodontology, University Hospital Leipzig, Leipzig (Director: Prof Dr Rainer Haak).

Prof. Dr. D. Ziebolz MSc.
Prof. Dr. D. Ziebolz MSc.

Prof Dr Dirk Ziebolz MSc is a senior physician at the Polyclinic for Dental Preservation and Periodontology, Leipzig University Medical Centre (Director: Prof Dr R. Haak); with focus on interdisciplinary dental preservation and health services research.

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