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Periodontal Treatment May Not Help To Control Blood Sugar
December 18, 2013

By Nancy Volkers
InteliHealth News Service

INTELIHEALTH - Standard treatment for gum disease does not improve blood-sugar control in people with fairly well controlled diabetes, a study concludes.

The study included 514 adults with type 2 diabetes. All of them also had moderate to severe gum disease.

People were randomly assigned to one of two groups. Over a six-month period, one group got two sessions of scaling and root planing. This is a "deep cleaning" of the teeth used to treat gum disease. This group also received an oral rinse at the start of the study. The second group received no treatment or rinse.

There were no differences between the groups that related to diabetes control or the seriousness of their gum disease. They also were similar in other ways, including general health, other medical conditions, race, age and smoking history.

After six months, there were no improvements in blood-sugar control in the treatment group. This group did not have lower fasting blood-sugar measurements. It also did not have lower levels of hemoglobin A1C. This is a blood protein used to measure blood-sugar control.

The treatments did improve gum disease symptoms. After six months, the treatment group had smaller gaps between gums and teeth, and less bleeding of the gums.

This is the largest known randomized study to look at the effects of gum-disease treatment on blood-sugar control. A randomized study blindly assigns people to different treatments or to no treatment.

At the start of the study, the average A1C level in the groups was about 7.8%. According to the American Diabetes Association (ADA), doctors should consider changing, adding or adjusting treatment in people with diabetes who have A1C levels above 8.0%. The ADA suggests a goal A1C of 7.0%.

Previous studies have suggested that treating gum (periodontal) disease helps to control blood sugar in people with diabetes. A review of published research showed that gum disease treatment led to a decrease in A1C. In that study, however, the average A1C was higher: about 8.75%.

The study appears in the December 18 issue of the Journal of the American Medical Association.

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