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Increased glycemia andglycated hemoglobin. A blood test that reveals the values of these two parameters can allow a diagnosis of diabetes and therefore allow the doctor to implement the necessary remedies case by case, starting from the lifestyle.
Unfortunately, often those with type 2 diabetes, the most common form, do not know they are sick and, while waiting for the diagnosis, there is a risk that the complications related to the disease, especially in the blood vessels, go on.
It is therefore essential to get to suspect the condition early, through a screening that can also start from visit to the dentist and “double” with the diabetologist. This is the proposal that comes from a document of the Italian Society of Periodontology and Implantology (SIdP) with the Italian Society of Diabetology (SID) and the Association of Diabetologists (AMD).
Double-sided diseases
Although often unknown, periodontitis, or extensive inflammation of the gums, leads to a increase 20% odds of develop diabetes so much so that this condition of the mouth represents the sixth most frequent complication in the diabetic.
During the follow-up visit. the dentist can identify patients with gingival inflammation for whom a blood glucose test is appropriate, while the diabetologist during the periodic visit will have to pay attention to symptoms such as bleeding, swelling or gum pain and hypersensitivity or dental mobility, inviting patients to dental check-ups annual even in the absence of symptoms.
“Periodontists can play a key role in the interception of people at high risk of developing diabetes and in the early diagnosis of this disease in those who do not know they are affected: from today there is a shared tool to do this, thanks to the new document joint SIdP – AMD – SID that establishes the rules for screening – explains Luca Landi, SIdP president.
The dentist can identify patients who should be tested for blood glucose simply by asking them a few questions. All over 45 with periodontitis who have not checked blood sugar levels for over 3 years and all patients with a body mass index above 25, therefore overweight or obese, who have at least one of the risk factors such as family history of type 2 diabetes, hypertension or ongoing antihypertensive therapy, low HDL cholesterol and / or high triglycerides, sedentary lifestyle. In women, childbirth of a newborn weighing over 4 pounds or polycystic ovary syndrome are risk factors. It is equally important to pay attention, during the visit, to symptoms reported by the patient and indicative of diabetes such as polydipsia and polyuria, recurrent genitourinary infections, weight loss and asthenia ”.
The role of the diabetologist
The diabetes specialist, on the other hand, represents the other side of this double screening. In addition to informing his patients of the increased risk of periodontal disease and the red thread that links the two diseases, he can inform son the importance of checking teeth and gums, asking the patient during the follow-up visit if he has gum bleeding, swelling or discomfort, hypersensitivity or mobility of the teeth, halitosis.
And the advice of the dentist is indicated in case of dry mouth, burning or the appearance of whitish patches indicative of mycosis, the diabetologist should also motivate them to undergo annual checks even in the absence of pain or other symptoms, given the prevalence of periodontitis in diabetics .
The document also recommends doctors to inspect the oral cavity, with particular attention to the gums, at the first visit and subsequent checks.
“Periodontal disease must certainly be counted among the pathologies to which people with diabetes are, in relation to non-diabetics, more predisposed – points out Agostino Consoli, President of the Italian Diabetes Society – It can in fact be considered one of the complications of diabetic disease. A first screening of periodontal disease (both anamnestic and inspection) must certainly be part of the diabetic visit but, above all, the person with diabetes should also be educated by the diabetologist about oral hygiene and encouraged to undergo regular oral hygiene sessions “.
“Diabetes and periodontitis are two closely related conditions. Diabetes can be associated with an increase in gingivitis and chronic periodontitis, with a risk for the person with diabetes up to 2-3 times greater than for a person who is not affected – comments Paolo Di Bartolo, president of AMD. “The watchword is once again prevention. Through screening interventions it will be possible to guide those subjects who ignore their condition to an early diagnosis of diabetes with the aim of intervening promptly and reducing the risk of complications. The collaboration started together with SIdP and SID confirms the importance of providing assistance that is as integrated as possible to protect the health of our people ”.
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