The Oral Cavity provides an opportunity to recognize systemic diseases early in their onset. If a dentist suspects a patient is diabetic but cannot confirm the diagnosis, both the dentist and patient are placed at considerable risk.

Recent Survey Results of  Dental Patients:

  • 72% said they usually bleed when getting their teeth cleaned at their dentist
  • 93% said their dentist does not do an oral cancer exam
  • 100% said their dentist did not do blood pressure checks
  • 100% said their dentist does not do blood screenings
  • 68% said they would consider going to another dentist offering more advanced services if the dentist was similar in cost 

Chronic and Systemic diseases that manifest in the mouth include:

  • Diabetes
  • Anemia and Blood Disorders
  • Heart Disease
  • Osteoporosis
  • 23.6 million Indians have Diabetes, or 11% of population
  • 6.2 million are unaware and undiagnosed
  • 1 in 3 Families are touched by Diabetes
  • 93 % of diabetes is Type 2 or adult onset, with obesity serving as the primary risk factor

Why People Aren’t BeingT ested for Diabetes

Lack of Awareness

  • Patients do not know the full impact of the disease
  • Patients do not recognize the warning signs .

Incomplete Education

  • Patients have not been educated on the disease complications

Misconceptions about Testing

  • May have been previously tested for Fasting Glucose (only)
  • May believe that testing is complicated or expensive

Absence of a Professional’s Call to Action

  • A doctor has not prompted the patient to be tested

Why Dentists and Why Now?

  • Historical diabetes screening lacks convenience and sensitivity as evidenced by the number of undiagnosed diabetics
  • Criteria for detecting diabetes has not changed in nearly 50 years, with fasting blood glucose serving as the primary test
  • Health care consumers are more likely to see their dentist than primary care physician
  • A study reveals that most consumers (85%) believe there is a strong connection between oral health and overall medical health

Dentistry andDiabetes: A Two-Way Street

  •  “Diabetes can adversely affect oral health, and poor oral health can worsen diabetic complication.”
  • “Diabetes leads to unwanted changes in gums and periodontal tissues.”
  • “Significant data now support that if a person has diabetes and they also have periodontal disease that is left untreated, it is very difficult to gain glycemic control of the patient.”
  • “Periodontal disease including gingivitis and periodontitis worsens diabetes when bacteria released into the blood stream contribute to inflammation.”
  • High blood glucose levels make the periodontium susceptible to injury, as the microvasculature undergoes repeated cycles of dehydration and swelling.
    • Bleeding gingiva are now recognized as one of the earliest indicators of diabetes
  • High blood glucose levels are a source for the bacteria-rich biofilm matrix of dental plaque, increasing the likelihood of bacteremia or a blood-borne bacterial event.

List the Most Common Risk Factors of Diabetes:


  • Ethnicity - African Americans, Hispanics andAmerican Indians are at 2x risk
  • Family History- Father, Mother, Brother or Sister with Diabetes doubles your risk of type 2 Diabetes
  • Age - Incidence of type 2 diabetes increases at age 45


  • Physical Inactivity - Lack of regular cardio exercise increases diabetes risk
  • Hypertension - High Blood Pressure increases risk of type 2 Diabetes
  • Weight - Obesity is the fastest growing preventable cause for type 2 Diabetes.

Diagnostic Tests for Diabetes:

Fasting Blood Glucose

  • After overnight fast of 8 hours
  • Levels >126 mg/dL are diagnostic for diabetes
  • Levels >100 mg/dL and <126 mg/dL are indicative of pre-diabetes

Glucose Tolerance Test

  • In a fasting state, a beverage containing 75g of glucose is taken orally.
  • Glucose levels tested in the fasting state, and hourly up to 5 hours.
  • One hour glucose levels >200 mg/dL arediagnostic for diabetes.

Hemoglobin A1c

  • Blood hemoglobin binds with excess glucose, the percent of glucose-bound hemoglobin can be determined in a blood sample.
  • Since red blood cells live for 90-120 days, the level of HbA1c is indicative of the blood glucose levels over the past 3months.
  • Levels <6.0% are considered normal, andvalues >6.5% considered as high risk for diabetes.


  • Awareness
  • Education
  • Testing
  • Call to Action