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:
- Anemia and Blood Disorders
- Heart Disease
- 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 .
- 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:
THOSE WHICH CAN NOT BE CHANGED
- 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
THOSE WHICH CAN BE CHANGED
- 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.
- 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.
- Call to Action