Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Comment
  • Published:

Periodontics

Does periodontal treatment improve glycaemic control in periodontitis patients with diabetes mellitus?

Abstract

Data sources

The electronic databases Cochrane Oral Health’s Trials Register, Cochrane Central Register of Controlled Trials, MEDLINE Ovid, Embase Ovid, CINAHL EBSCO, LILACS BIREME Virtual Health Library from inception to September 2021, along with trial registers and journals (hand searching) were searched to identify the randomized controlled trials (RCTs).

Study selection

Two reviewers independently identified and selected RCTs of at least three months’ duration, comparing the effectiveness of subgingival instrumentation relative to no active intervention or usual care (oral hygiene instruction, education, or supportive interventions, and/or supragingival scaling) in the reduction of glycated haemoglobin (HbA1c) in periodontitis patients with type 1 or 2 diabetes mellitus.

Data extraction and synthesis

Data extraction and risk of bias assessment were performed by two reviewers independently. Data were synthesized quantitatively with meta-analyses using a random-effects model, and pooled outcomes were expressed as mean differences with 95% confidence intervals. In addition, subgroup analysis, heterogeneity assessment, sensitivity analyses, summary of findings, and assessment of the certainty of the evidence were performed.

Results

Out of 3109 identified records, 35 RCTs were included for qualitative synthesis, and amongst them, 33 studies were included for meta-analysis. Meta-analyses showed that periodontal treatment with subgingival instrumentation, compared to usual care or no treatment, led to a mean absolute reduction of 0.43% in HbA1c at 3 to 4 months, 0.30% at six months, and 0.50% at 12 months. The certainty of the evidence was assessed to be moderate.

Conclusions

The authors concluded that periodontitis treatment by subgingival instrumentation improves glycaemic control in diabetic patients. However, there is insufficient evidence about the effect of periodontal treatment on quality of life or diabetic complications.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37(Suppl 1):S81–90.

    Article  Google Scholar 

  2. Cade WT. Diabetes-related microvascular and macrovascular diseases in the physical therapy setting. Phys Ther. 2008;88:1322–35.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Löe H. Periodontal disease. The sixth complication of diabetes mellitus. Diabetes Care. 1993;16:329–34.

    Article  PubMed  Google Scholar 

  4. Genco RJ, Graziani F, Hasturk H. Effects of periodontal disease on glycemic control, complications, and incidence of diabetes mellitus. Periodontol 2000. 2020;83:59–65.

    Article  PubMed  Google Scholar 

  5. Williams RC Jr, Mahan CJ. Periodontal disease and diabetes in young adults. J Am Med Assoc. 1960;172:776–8.

    Article  PubMed  Google Scholar 

  6. Falcao A, Bullón P. A review of the influence of periodontal treatment in systemic diseases. Periodontol 2000. 2019;79:117–28.

    Article  PubMed  Google Scholar 

  7. Oates TW, Guy V, Ni K, Ji C, Saito H, Shiau H, et al. Meta-regression analysis of study heterogeneity for systemic outcomes after periodontal therapy. JDR Clin Trans Res. https://doi.org/10.1177/23800844211070467 2022.

  8. Simpson TC, Weldon JC, Worthington HV, Needleman I, Wild SH, Moles DR, et al. Treatment of periodontal disease for glycaemic control in people with diabetes mellitus. Cochrane Database Syst Rev. 2015;2015:CD004714.

    PubMed  PubMed Central  Google Scholar 

  9. Simpson TC, Clarkson JE, Worthington HV, MacDonald L, Weldon JC, Needleman I, et al. Treatment of periodontitis for glycaemic control in people with diabetes mellitus. Cochrane Database Syst Rev. 2022;4:CD004714.

    PubMed  Google Scholar 

  10. Critical Appraisal Skills Programme (2018). CASP (Systematic Review) Checklist. [online] Available at: https://casp-uk.net/casp-tools-checklists/; Date Accessed: December, 2022.

  11. Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kunaal Dhingra.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dhingra, K., Jeng, JH. Does periodontal treatment improve glycaemic control in periodontitis patients with diabetes mellitus?. Evid Based Dent 24, 12–14 (2023). https://doi.org/10.1038/s41432-023-00863-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41432-023-00863-x

Search

Quick links