Effectiveness of Non-Surgical and Surgical Periodontal Therapy in Lowering HbA1c in Diabetic Patients

Abstract

Diabetes is global pandemic disease, a metabolic disorder of multiple etiology that is characterized by chronic hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Periodontitis is a chronic inflammatory disease that is initiated by the accumulation of dental plaque biofilm, within which microbial dysbiosis leads to a chronic, non-resolving and destructive inflammatory response. In the last decades, many studies investigated the impact of periodontal treatment on glycemic control in people with diabetes. The aim of this dissertation is to conduct a review of the published literature to understand the association between periodontal therapy and glycated hemoglobin (HbA1c) values. A search was conducted in PUBMED and of the 277 articles found, only 21 were considered for being more relevant. As has been recognized for some time, the results show a correlation between the two diseases and their link lies in the inflammatory process. In the diabetic patient, this results in higher HbA1c values and a situation that is difficult to control. Being able to control the inflammatory state of the periodontium through oral hygiene protocols and periodontal therapy has several benefits in a complicated clinical picture in situations of poor glycemic control. Non-surgical periodontal therapy proves effective in significantly lowering HbA1c levels in diabetic patients.