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The effects of periodontal treatment on diabetes.

BACKGROUND
Diabetes mellitus and periodontal diseases are common chronic diseases in the United States. Periodontal infection may adversely affect glycemic control in people with diabetes. This article reviews the evidence regarding how treatment of periodontal diseases affects glycemic control.


TYPES OF STUDIES REVIEWED
The review consisted of a MEDLINE literature search to identify primary research reports on the relationship between periodontal therapy and changes in glycemic control. The review identified three randomized clinical trials and nine nonrandomized clinical follow-up studies.


RESULTS
The strength, quantity and breadth of evidence are varied, precluding clear-cut guidance for determining whether treating periodontal infection has a beneficial effect on glycemic control. Despite the variation and limitations in the literature, evidence supports the concept that periodontal diseases can contribute to poorer glycemic control in people with diabetes. Although the evidence is not unequivocal, it provides sufficient support for additional investigations of the effect of preventing and treating periodontal infections on managing glycemic control.


CLINICAL IMPLICATIONS
Sufficient evidence exists to incorporate oral examinations and periodontal care in management regimens for people with diabetes. It is prudent to assess patients' glycemic control status and communicate the importance of referring patients with diabetes for thorough oral health evaluations and necessary care.