A new study conducted by researchers at Columbia University College suggests that dental visits are an opportunity for dentists to identify patients with diabetes or pre-diabetes who were previously unaware of their condition.
"Periodontal disease is an early complication of diabetes, and about 70 percent of U.S. adults see a dentist at least once a year," says Dr. Ira Lamster, dean of the College of Dental Medicine, and senior author of the paper. "Prior research focused on identification strategies relevant to medical settings. Oral health care settings have not been evaluated before, nor have the contributions of oral findings ever been tested prospectively."
The study, which appeared online in the April 29 Journal of Dental Research, developed and evaluated an identification protocol for high blood sugar levels in dental patients. They recruited approximately 600 individuals visiting a dental clinic in Northern Manhattan who were 40-years-old or older (if non-Hispanic white) and 30-years-old or older (if Hispanic or non-white), and had never been told they have diabetes or pre-diabetes.
The researchers chose some 530 patients with at least one additional self-reported diabetes risk factor, such as having a family history of diabetes, high cholesterol, hypertension or being overweight or obese for participation in the study. The patients received a periodontal examination and a fingerstick, point-of-care hemoglobin A1C test. The patients were asked to return for a fasting plasma glucose test to help determine whether a person had diabetes or pre-diabetes.
They discovered that looking at two dental parameters—in this case the number of missing teeth and percentage of deep periodontal pockets—was all that was needed to correctly identify 73 percent of patients with unrecognized pre-diabetes or diabetes. Adding the point-of-care A1C test resulted in correct identification of 92 percent of these patients
"Early recognition of diabetes has been the focus of efforts from medical and public health colleagues for years, as early treatment of affected individuals can limit the development of many serious complications," says Dr. Evanthia Lalla, an associate professor at the Columbia dental school, and the lead author. "Relatively simple lifestyle changes in pre-diabetic individuals can prevent progression to frank diabetes, so identifying this group of individuals is also important," she adds. "Our findings provide a simple approach that can be easily used in all dental-care settings."
The researchers cited statistics from the Centers for Disease Control and Prevention that say one in four people affected with type 2 diabetes in the U.S. remains undiagnosed. The CDC also says that individuals with diabetes or pre-diabetes have an increased risk for heart disease, stroke and other vascular conditions associated with diabetes.
The study was supported by a research grant from Colgate-Palmolive and the authors reported no potential financial or other conflicts.
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