World Diabetes Day is November 14. We spoke to the experts about the prevalence of diabetes in the community, the impact diabetes can have on a person’s oral health, and when to refer to a periodontist.
How often do you see a patient who has diabetes? “In Western Australia alone, there are more than 128,000 people now diagnosed with diabetes and for every person diagnosed, it is estimated there is another person who has diabetes but does not know it yet,” says Cate Mitchell, Credentialled Diabetes Educator at Diabetes WA (Statistics from ABS 2022).
Oral health symptoms for people with diabetes
“In people with diabetes we can see an increased prevalence of periodontal disease and xerostomia, with its associated side effects such as root surface caries,” says Periodontist, Dr Amy Hope. “In older people with diabetes, burning mouth syndrome, angular cheilitis and glossitis are more commonly seen.”
Cate says the risk of tooth decay, gum disease, and oral gum infections are more common in people with high blood glucose levels.
“Dentists and dental care workers should be encouraging, promoting and reminding their clients to have a dental review done every six months,” she says. “If they can, to include educating their patients about good gum and teeth hygiene with demonstrations of how to care for their teeth and to improve their ability to follow the best care practice is highly beneficial to prevent complications.”
Jessica Weiss, Tele-Services Manager at Diabetes WA, says in addition to the impact diabetes and its management can have on oral health, diabetes medications can also play an impact:
Jessica adds dentists are also ideally placed to identify early signs of diabetes or identify those at risk.
“It is also of note if someone living with diabetes is having regular low glucose levels, they would be more regularly requiring emergency oral glucose treatments, which may impact oral health,” she says. “Linking people with diabetes in with a diabetes educator to support their diabetes management can also support their oral health.”
When to refer a patient to a Periodontist
“When the general dentist is unable to manage deeper pocket depths or anatomy (such as furcation involved teeth), and the periodontal disease is not responding to therapy, a referral should be arranged,” Amy advises. “A patient that has poorly controlled diabetes with periodontitis is a high risk for disease progression and
should be reviewed on a three-monthly basis and referral made if no improvement to periodontal health has occurred.
“There is also a reciprocal relationship between progression of periodontal disease and diabetes and the patient should be made aware of this to gain control of both diseases.”
Resources on diabetes for health professionals
Wanting to learn more about diabetes? Jessica recommends the following:
Diabetes WA Training
As West Australia's peak body for diabetes, Diabetes WA offers a suite of training programs combining the latest in evidence-based recommendations in diabetes care with self-management principles. Training programs are created and delivered by a team of credentialled diabetes educators who bring their experience and local knowledge from working with the unique and varied regions across Western Australia.
We offer a variety of training options for support workers, health professionals, early childhood educators, and school staff supporting children with type 2 diabetes.
Training can be scheduled in person or via video conference at a mutually convenient date and time. Please contact firstname.lastname@example.org for more information.
GP Helpline 1300 001 880
Credentialed diabetes educators provide diabetes medication and insulin advice.
Available Monday to Friday
8:30am - 4:30pm
Online learning for health professionals
We have a range of learning programs to help health professionals strengthen their knowledge and understanding of diabetes.
Health workforce education program
The National Diabetes Services Scheme NDSS has released a new online program for the health workforce, the NDSS health workforce education program. This program enables health professionals and workers to learn more about diabetes, and the support and services available through the NDSS.
The online program is free and covers 6 topics including, the NDSS, Diabetes explained, Medication and monitoring, and Diabetes-related complications.
Health Professional webinars
The National Diabetes Services Scheme has finalised their health professional webinar schedule, providing two educational webinars each month. The webinars will take place on the first and third Tuesday of each month from 6-7pm.
Amy recommends the reading the paper, Sanz et al 2020. Scientific evidence on the links between periodontal diseases and diabetes: Consensus report and guidelines of the joint workshop on periodontal diseases and diabetes by the International Diabetes Federation and the European Federation of Periodontology.
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