Scaling and root planing may improve blood sugar control of diabetes patients

The study is published in the BMC Oral Health Journal.

Treating periodontitis through non-surgical periodontal therapy (NSPT) may improve blood sugar control in type-2 Diabetes Mellitus (T2DM) patients. However, the evidence to maintain this improvement beyond four months is insufficient.

Therefore, Ambrina Qureshi and associates from the Department of Community and Preventive Dentistry, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan conducted this three-arm randomized controlled trial to assess clinical efficacy of NSPT on glycemic control in T2DM patients.

The trial recruited 150 known T2DM participants between the age group of 35–65 years, suffering from moderate to severe periodontitis, having HbA1c level ≥ 6.5% at baseline. Participants were followed up at 3 and 6 months.

Intervention for test group-1 included scaling and root planing (SRP) with metronidazole (MET) and oral hygiene instructions (OHI). Test group-2 was intervened with SRP + OHI and control group with OHI only. Stata v. 14 was used to observe inter and intragroup mean changes in glycemic [glycated hemoglobin (HbA1c), fasting blood glucose (FBG)] and periodontal variables [bleeding on probing (BOP), periodontal pocket depth (PPD), clinical attachment loss (CAL)] using ANOVA and RMANOVA.

Proportion of change in outcome variable (HbA1c) was assessed between treatment groups using chi-square test. Change was considered significant at p-value ≤ 0.05.

The study revealed that there was a significant reduction observed in BOP, PPD, CAL, HbA1c and FBG over time [p < 0.05]. Significant reductions were also observed in same variables in both test groups in comparison to control arm [p < 0.05]. No change between the two test groups was observed [p > 0.05].

Hence, the authors concluded that "SRP with or without MET is significantly efficacious in not only reducing periodontitis but also for glycemic control in T2DM patients suffering from higher levels of HbA1c at baseline. Therefore, SRP + OHI without added load of MET at 6 months may be suggested and included as a part of overall diabetes management."