Diabetes/Perio

Question 1

Briefly outline the bi-directional relationship between diabetes and periodontitis

Answer 1

• diabetics with sub- optimally controlled glycaemic index have a 3 fold increase in developing periodontitis
• patients with T2DM who have periodontitis are more likely to experience diabetic complications
• perio patients who do not have diabetes often have higher HbA1c levels and thus are at an increased risk of developing diabetes

Question 2

What oral complications are associated with diabetes

Answer 2

• risk of dry mouth
• increased risk of caries
• increased risk of periodontitis
• poor wound healing following periodontal treatment
• increased risk of candida/opportunistic infections

Question 3

What advice/treatment can be provided to diabetic patients ?

Answer 3

• diet diary
• diet advice- according to eatwell guidance
• saliva stimulating
• for patients with sub-optimally controlled diabetes; if patient is currently struggling on current meds, liaise with GP for possible alternative medication

Question 4

What is an oral presentation of someone with undiagnosed type II diabetes?

Answer 4

recurring periodontal abscess

Question 5

Outline some recommendations made by the eatwell guidance

Answer 5

• at least 5 portions of fruit and vegtables a day
• starchy foord should make up just over a third of the food we eat ; choose higher fibre, or wholegrain varieties such as wholewheat pasta or brown rice, leave skins on potatoes
• aim for at least 2 portions of fish every week, one of which shoud be oily
• Include diary; milk, cheese etc are good sources of protein and calcium; try to go for lower fat and lower sugar products where possible
• choose unsaturated oils and spreads
• eat foods high in fat, salts and sugars less often and in small amounts
• drink plenty of fluids- government recommends 6-8 cups/glasses a day

Question 6

The eatwell guidance does not apply to …

Answer 6

children under the age of 2
this is because they have different nutritional needs

Question 7

Why is it important to treat periodontitis in diabetic patients?

Answer 7

this is because it can improve blood sugar control and fat levels in diabetic patients