Interview: “Dentists play an important part in managing patients with diabetes”
Today is European Oral Health Day, initiated by the Council of European Dentists (CED), and this year it focuses on the theme “Oral health and diabetes”. The number of people suffering from diabetes has increased significantly; however, public awareness of the prevention of oral disease in diabetic patients is rather poor. Dental Tribune ONLINE spoke to Dr Hendrike van Drie, chair of the CED Working Group Oral Health, about the disease’s negative impact on oral health and the important role of the dentist.*
Dr Van Drie, this year’s European Oral Health Day addresses oral health and diabetes. How does diabetes affect oral health?
Diabetes is a disease with concomitant oral manifestations that affect dental care. It is often associated with periodontal disease. Diabetes is a risk factor for periodontal disease and studies have found a significantly greater rate of progression of periodontal disease among people with diabetes compared with those without the disease. Glycaemic control and periodontal status have a bidirectional relationship: careful glycaemic control results in improved periodontal status and vice versa. Periodontal disease can be considered the sixth “-pathy” of diabetes.
In Europe, about 60 million people have diabetes, according to the World Health Organization. This amounts to every tenth person over the age of 25. How many of those people affected do you think are aware of their significant oral health risk due to their diabetes?
Public awareness of the prevention of oral disease in diabetic patients is rather poor. The vast majority of people with diabetes live in low- and middle-income regions. These population groups face a higher burden of diabetes and a greater barrier to prevention and care.
The choice of this year’s theme was based on the currency of the issue of oral health and diabetes. During the last decade, the number of people with diabetes increased dramatically in the EU and around the world, yet public awareness of oral disease prevention in diabetic patients has remained low, as I have already mentioned. Therefore, European Oral Health Day presents an important opportunity to raise awareness about the links between diabetes and oral health, and about the important role of dentists in the management and treatment of patients with diabetes across the EU. The increase in the number of people with diabetes in Europe means higher health care costs. Currently, health care costs equate to 10 per cent of all costs in 2013 and are expected to increase from €109 billion to €117 billion by 2035. The costs associated with diabetes include increased use of health services, productivity loss and disability, which can be a considerable burden to the individual, families and society.
What can dentists do to support diabetic patients?
In years to come, dental practitioners will encounter an increasing number of patients with diabetes. Dentists can and do increasingly play an important part in the management and treatment of patients with diabetes. They can help them to maintain their oral and nutritional health, and encourage them to perform daily glucose monitoring tests and visit health professionals for routine care. Understanding of the disease and familiarity with its oral manifestations not only promote oral health in patients with diabetes, but also enhance their quality of life.
More specifically, dentists treating patients with diabetes should look for adverse effects in the oropharyngeal region. They see patients on a regular basis; thus, they can be instrumental in the early detection of symptoms and treatment of diabetes by recording a patient’s medical history and frequently updating it. When any indication of diabetes is present, dentists can refer patients to medical doctors for further diagnosis and treatment planning.
Dentists have greater access to healthy patients than do other medical professionals owing to preventive visits, giving them the opportunity to communicate with patients before onset of the disease. They often also have more time with patients than do many other health professionals, and this gives them the opportunity to integrate education and intervention methods into their practice, and to advise their patients about maintaining good oral hygiene and following a healthy diet.
Dentists can administer optimal periodontal care for patients with diabetes, as well as monitor symptoms requiring oral health care and treatment on an ongoing basis and arrange the appropriate treatment.