The British Society of Periodontology (http://www.bsperio.org.uk), together with Diabetes.co.uk (http://www.diabetes.co.uk), is running a campaign to raise awareness of the increased risk of gum disease in people living with diabetes.
Periodontal (gum) disease is the 6th most common disease in the world. You are all aware of the impact it can have on quality of life, include
bleeding gums, receding gums, loosening teeth, discomfort when chewing and eventually tooth loss. However, as you know, the good news is that it can
be prevented and easily treated in the early stages of the disease.
How are Gum Disease and Diabetes linked?
Diabetes.co.uk and the British Society of Periodontology recently carried out a survey of people living with diabetes. It showed three quarters of them had experienced bleeding gums when brushing. Worryingly only around 50% had ever received information about gum disease from either a dentist, or a doctor or a pharmacist.
Poorly managed blood sugar levels in people with diabetes cause damage to nerves, blood vessels, the heart, the kidneys, the eyes and the feet. In the same way, the gums can also be affected. The damage to the blood vessels, make infections of the gums, and the bone supporting the teeth, more likely. Poorly controlled blood sugar levels lead in turn to a rise in sugar levels in saliva, which feeds the bacteria and increases the formation of dental plaque.
Evidence shows that severe periodontal disease can increase blood sugar levels in people with diabetes and also in those who do not have diabetes. Interestingly, there is some scientific evidence to suggest that having treatment for gum disease can improve long-term blood glucose levels in people with poor control. This in turn lowers the risk of experiencing the other common long-term complications of diabetes, including heart and kidney disease.
In other words, we now know that periodontal disease and diabetes are linked in both directions.Keeping blood glucose levels low and stable can reduce
the risk of gum disease; and looking after oral health could help to improve long-term outcomes in people living with diabetes.
How can you as dental hygienists and dental therapists help people living with diabetes?
Dental hygienists and dental therapists can help patients with diabetes by taking the following steps:
Ask: Ask all patients with diabetes if they know that gum disease might be a complication of their diabetes and that gum disease can affect their diabetes care.
Assess: Liaise with the patient’s dentist and screen for the presence of periodontal disease using the Basic Periodontal Examination:
Act: Provide treatment as appropriate according to the British Society of Periodontology guideline: http://www.bsperio.org.uk/publications/downloads/90_123718_bpe-_bham_bsp-2016.pdf
If no periodontitis is diagnosed initially the patient should be placed on a preventive care programme and monitored regularly for any changes in periodontal status.
If treating the patient under direct access write to the patient’s doctor including details of the diagnosis and treatment and inform the doctor of the increased risk of periodontal disease in the patient. If the treatment is provided on prescription liaise with the dentist over writing to the patient’s doctor. The following template available on the BSP website may be useful:
The following poster for healthcare professionals explains the key messages:
The following patient poster can be displayed in waiting rooms:
We as dental care professionals must help patients living with diabetes by giving them the information they need to take responsibility for their oral health? As well as reducing the risk of contracting periodontal disease there are a host of reasons why good dental health habits are important including: to reduce the risk of tooth decay; to have fresh breath and to increase self esteem. It has been shown that people have less respect for those with poor oral hygiene, which can impact on workplace opportunities.
Patients may find it useful to visit the British Society of Periodontology website for further information including the recently updated patient information leaflet.
The British Society of Dental Hygiene and Therapy (BSDHT) is a nationally recognised body that represents over 4,000 Dental Hygienists and Dental Therapists across the UK and beyond.
BSDHT maintain an on-going dialogue with the General Dental Council (GDC), the Departments of Health and all of the main groups representing dental care professionals, and attends meetings of the All Party Parliamentary Group (APPG) for Dentistry, bringing dental hygiene and therapy to the attention of government ministers and MP’s.
Visit www.bsdht.org.uk for more information.
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