How Dental Teams Can Help Detect Type 2 Diabetes

A study led by researchers at the University of Birmingham in the United Kingdom suggests oral health professionals play a vital part in identifying people at high risk of developing pre-diabetes and type 2 diabetes. “Dental teams have a unique and special rapport with patients, as we are often in the privileged position whereby we see our patients at regular intervals — often over many years. This means we build strong professional relationships with, and are trusted by our patients, who regard our advice in a way perhaps they wouldn’t have had we not built the relationship over such a timeframe,” says Zehra Yonel, a PhD student and National Institute for Health Research and Diabetes UK Doctoral Research Fellow.

The paper, “The Role of the Oral Healthcare Team in Identification of Type 2 Diabetes Mellitus: A Systematic Review,” published in Current Oral Health Reports, builds on joint international guidance published last year on periodontitis and diabetes. Those recommendations included the need for oral healthcare professionals and physicians to work together more closely.

In this systematic review, electronic databases were searched for studies reporting the identification of pre-diabetes and or type 2 diabetes in specialist care dental settings. Of 52 eligible studies, 12 focused on stakeholder opinions on identification of type 2 diabetes by oral health professionals. The opinions of patients, dentists, dental hygienists, dental students and physicians regarding identification of type 2 diabetes by oral health professionals were generally positive, according to researchers. 

“The study shows that all key stakeholders — including patients, dental teams and physicians — are in support of utilizing the dental workforce to risk assess for type 2 diabetes. They are also willing to undertake the relevant risk assessment processes, to explain the results, and to liaise with the relevant members of the healthcare team to ensure that patients have the most appropriate follow-up care,” says Yonel. 

Among the studies that asked patients whether they felt it was important that dental professionals identify individuals at high risk of type 2 diabetes, patient support was strong (73% to 87%). 

Most patients surveyed were also willing to undergo chairside screening methods that resulted in immediate results. When used in a dental setting, risk assessment tools may lead to better outcomes for patients and improved management of the disease, researchers said.

Past studies have linked severe periodontitis to Type 2 diabetes, as individuals with undiagnosed or poorly controlled type 2 diabetes are more likely to present with periodontal disease. Clinical signs of diabetes can be identified during a dental exam, such as oral candidiasis. 

“Evidence now exists that dental teams undertaking thorough treatments of patients’ gingival health can actually help manage patients’ blood sugar levels and help to improve patients’ diabetes control,” says Yonel. 

Dental hygienists, dentists and other members of the dental team surveyed expressed willingness to conduct diabetes screening and believe in the importance of diabetes monitoring in the dental office. But barriers remain. 

The central barriers to undertaking diabetes screening in the dental setting were time, cost, inadequate training, and low follow-up of patients by primary care physicians.

“Medical and dental collaboration is not just important, but imperative for patient well-being,” says Yonel. “Closer collaboration between the two professions can only benefit patients, as both healthcare teams are highly skilled in the delivery of preventive and management strategies. This is critical for conditions such as diabetes, which have implications both for a patient’s medical health and oral health, due to the strong associations between diabetes and periodontal disease.”