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Can Dentists Identify Undiagnosed Diabetes and Prediabetes?


The next time your dentist says “open wide,” he or she may find something more than cavities. A Columbia University College of Dental Medicine study reports that the presence of two common dental conditions provides a way for dentists to identify undiagnosed prediabetes and diabetes.

Diabetes affects your oral health

People who have diabetes are susceptible to dental problems associated with poorly controlled blood sugar levels, which interfere with the ability of white blood cells to fight bacterial infections that can occur in the mouth.

Uncontrolled diabetes can cause a reduction in the flow of saliva, which results in dry mouth. A dry mouth can lead to tooth decay (and ultimately tooth loss), mouth ulcers, and soreness. People with diabetes are also more likely to develop gum disease (e.g., gingivitis and periodontitis), and they do not heal as well or as quickly following dental procedures or oral surgery.

Diabetes is a large and increasingly growing problem, and early detection—either prediabetes or diabetes itself--can help individuals take steps to minimize and even reverse the disease. Researchers at Columbia University have discovered that an unconventional resource for identifying the disease could be a dental chair.

The research team recruited about 600 adults age 40 years or older (if non-Hispanic white) and age 30 years or older (if Hispanic or non-white) who used a dental clinic in Northern Manhattan. Approximately 530 of them had at least one self-reported risk factor for diabetes (e.g., overweight, high cholesterol, family history of diabetes), but none of them had ever been diagnosed with prediabetes or diabetes.

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The participants underwent a periodontal exam and a hemoglobin A1c test, a blood test used to diagnose diabetes and also to monitor it. Test results reflect a person’s average blood sugar level for the past two to three months. Patients also returned for a fasting plasma glucose test, which can identify whether a person has prediabetes or diabetes.

Investigators found that two factors—the number of missing teeth and the percentage of deep periodontal pockets, which are grooves or depressions in the gums where bacteria collect—were effective in identifying patients who had undiagnosed prediabetes or diabetes. Use of the hemoglobin A1c test was also valuable in making the identification.

According to the study’s lead author, Dr. Evanthia Lalla, associate professor at the College of Dental Medicine, “our findings provide a simple approach that can be easily used in all dental-care settings.” The dental chair could be a convenient way to identify unrecognized disease, as “about 70 percent of U.S. adults see a dentist at least once a year,” stated Dr. Ira Lamster, dean of the College of Dental Medicine and the study’s senior author.

When dentists tell patients to open wide, they could hear news they don’t expect. As Dr. Lalla noted, “relatively simple lifestyle changes in pre-diabetic individuals can prevent progression to frank diabetes, so identifying this group of individuals is also important.”

Columbia University College of Dental Medicine

Picture source: Wikimedia Commons