The bacteria involved in periodontitis is different between diabetic and non-diabetic patients, according to a new study published in the Journal of Investigative and Clinical Dentistry.
For the study, researchers in Columbia studied the subgingival microbiota of periodontitis patients with and without diabetes. They tested for Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Aggregatibacter actinomycetemcomitans.
They found that in patients with diabetes A. actinomycetemcomitans was considerably more prevalent, but in patients without diabetes, P. gingivalis was the primary bacterium. Both these pathogens are highly virulent and invasive. A. actinomycetemcomitans has been significantly associated with heart disease, and it has been shown to work in cahoots with P. gingivalis to disrupt the body’s immune response. P. gingivalis, of course, has been linked to many organ systems and diseases, from Alzheimer’s disease to rheumatoid arthritis.
Study after study has shown that the relationship between diabetes and periodontal disease is not casual. There appears to be a bi-directional relationship between periodontal disease and glycœmic control among individuals with diabetes. In fact, recent research on the subject has found that periodontal disease is directly associated with increased insulin resistance and is predictive of future Type 2 diabetes. However, this is one of the first studies to note a pronounced difference in the oral microbiome of patients with and without diabetes.
While future research will undoubtedly seek to further investigate this intriguing distinction, it remains especially imperative to address the impact of oral bioburden on patients with insulin resistance or diabetes. A healthy mouth has been shown to reduce health complications from diabetes, improve blood sugar control, assist with lowering A1c levels, and reduce medical costs as much as 25% for patients with diabetes.
The coordination of care between integrative medical and dental professionals—along with advanced home care—will result in lowering of key markers, improved outcomes, and fewer complications for diabetic patients.