Periodontal disease and diabetes metabolic control: a full-mouth disinfection approach

Some studies demonstrated that local mechanical periodontal treatment and systemic antibiotics might improve the level of metabolic control in patients with diabetes. The aim of this clinical pilot trial was to evaluate if type 1 diabetes patients with periodontitis will experience improvement in periodontal status and glycemic control after a full-mouth disinfection treatment. Ten adult patients with poor metabolic control (mean glycated hemoglobin (HbA1c) = 10.7 %) and periodontitis were included in the study. All patients received a full-mouth disinfection in 24 hours as described by Quirynen et al. (1995) at baseline and 6 months later. The periodontal parameters included plaque index (PI), bleeding on probing, probing depth and clinical attachment loss. Metabolic control was measured by the serum level of HbA1c. All measurements were done at baseline and at 3, 6, 9 and 12 months. The results demonstrated a significantly lower PI, less bleeding on probing, reduction in probing depth and gain of clinical attachment at 3 months and 9 months of the study. Similarly, a significant reduction in the serum level of HbA1c was measured three months after full-mouth disinfection but disappeared 6 months later at the 6- and 12-month check points. We conclude that a full-mouth disinfection approach significantly improves periodontal status and metabolic control in type 1 diabetes patients with periodontitis. However, the results of our study imply that a full-mouth disinfection method has to be applied at least every 3 months to control periodontal status and glycemic control in type 1 diabetes patients. Further studies with greater numbers of diabetes patients are needed to confirm the long-term beneficial effects of a full-mouth disinfection approach on diabetic metabolic control.