Periodontal disease in common and a number of studies support an association between diabetes and periodontal disease. Some studies report that the prevalence of periodontal disease is 2.6 time higher in diabetics.

The aim of this review was to evaluate the effect of periodontal treatment on glycaemic control of diabetic patients.

Methods

Searches were conducted in PubMed, Embase and Cochrane Library for English language studies. Randomised controlled trials (RCTs) in adults over the age of 18 with diabetes and periodontal disease undergoing no-surgical periodontal treatment with or without adjunctive antibiotics were considered. Study selection was carried out independently by two reviewers Study quality was assessed using the Cochrane risk of bias tool.

Results

• 10 RCTs involving a total of 1135 patients were included
• Mean change in Hb1Ac
  • at 3 months meta-analysis (10 studies) = -0.36% (95%CI: -0.52% – 0.19%)
  • at 6 months ( 6 studies ) = – 0.30%, (95%CI: -0.69% to 0.09%)

Conclusions

The authors concluded

Periodontal treatment leads to the modest reduction in HbA1c along with the improvement of periodontal status in diabetic patients for 3 months, and this result is consistent with previous systematic reviews. And the effect of periodontal treatment on HbA1c cannot be observed at 6-month after treatment.

Commentary

This is the most recent in a number of systematic reviews of this topic (see links). The review by Corbella et al that we most recently considered ( Dental Elf- 26^th June 2014 ) included more studies (n=15) that this current review (n=10) and found a very similar mean difference for Hb1Ac at 3 months of -0.38 ((95% CI -0.23 to -0.5). Corbella suggested that their result meant that the clinical importance for diabetics was unclear and the fact that this review finds that the effects of periodontal treatment at not evident at 6 months supports that position.

Links

Wang X, Han X, Guo X, Luo X, Wang D. The Effect of Periodontal Treatment on Hemoglobin A1c Levels of Diabetic Patients: A Systematic Review and Meta-Analysis. PLoS One. 2014 Sep 25;9(9):e108412. doi: 10.1371/journal.pone.0108412. eCollection 2014. PubMed PMID: 25255331.

Dental Elf -26^th Jun-2014 – Periodontal treatment may be effective in improving metabolic control in diabetics but clinical significance is unclear

Teeuw WJ, Gerdes VE, Loos BG. Effect of periodontal treatment on glycemic control of diabetic patients: a systematic review and meta-analysis. Diabetes Care. 2010 Feb;33(2):421-7. doi: 10.2337/dc09-1378. Review. PubMed PMID: 20103557; PubMed Central PMCID: PMC2809296.

Engebretson S, Kocher T. Evidence that periodontal treatment improves diabetes outcomes: a systematic review and meta-analysis. J Periodontol. 2013 Apr;84(4 Suppl):S153-69. doi: 10.1902/jop.2013.1340017. PubMed PMID: 23631575; PubMed Central PMCID: PMC4100543.