International Experts Reach New Consensus on Links Between Diabetes and Periodontitis

Posted on March 2, 2017

Madrid, March 1, 2017. Experts from the fields of gum health and diabetes met in Madrid on February 19 and 20 for the Perio-Diabetes Workshop, a pioneering international summit that explored the latest evidence on the links between periodontal diseases and diabetes. The workshop reached a new scientific consensus on how these widespread chronic conditions reinforce each other and produced recommendations on how dentists and physicians can work more effectively together to help prevent and treat them.

Fifteen specialists from around the world took part in the Perio-Diabetes Workshop, jointly organized by the European Federation of Periodontology (EFP) and the International Diabetes Federation (IDF) in partnership with Sunstar and with participation of CIBERDEM. Both the EFP and the IDF are considered as global scientific benchmarks in their fields of expertise.

Their conclusions were the following:

-Periodontitis patients have a higher chance of developing prediabetes and type 2 diabetes.

-While there are no data to support a causal relationship between the periodontal microbiome, the microorganisms involved in gum disease, and the presence of diabetes, recent studies do show an association between altered glucose metabolism in prediabetes and diabetes and changes in the periodontal microbiome.

-There is a moderate level of evidence that certain biological mechanisms mediate the effect of periodontitis on the control of diabetes.

-There is evidence that improving the control of diabetes results in improvements to periodontal status and that improving periodontal health has benefits in improving metabolic control and/or the complications of diabetes.

Guidelines drawn up by the workshop include providing oral-health education to all patients with diabetes and informing them that they have a greater risk of periodontal disease, which, if left untreated, could have a negative impact on metabolic control and may also increase the risk for complications including cardiovascular and kidney disease. Patients should also be advised that successful periodontal therapy can have a positive impact on their metabolic control and complications.

The Perio-Diabetes Workshop was held at the SEPA Gum Health Centre in Madrid during February 19 and 20. Discussions focused around three key points:

a) Evidence of pathogenic mechanisms that may link periodontitis and diabetes, based on a report authored by diabetologist David Polak and periodontist Lior Shapira, of the Hebrew University-Haddasah School of Dental Medicine in Jerusalem, Israel.

b) Epidemiological observational evidence on the effect of periodontal disease on diabetes, based on a systematic review and meta-analysis written by periodontist Filippo Graziani and diabetologists Stefano Gennai, Anna Solini and Morena Petrini of the University of Pisa, Italy.

c) Evidence on the potential impact of periodontal therapy on diabetes outcomes, based on an update by Phoebus Madianos of the University of Athens, Greece, who is also chair of the EFP’s scientific affairs committee.

The Perio-Diabetes Workshop was co-chaired by Prof Mariano Sanz (EFP, Spain) and Prof Antonio Ceriello (IDF, Italy). The other EFP participants were Prof Iain Chapple (United Kingdom, secretary general), Prof Juan Blanco (Spain, president), Prof Filippo Graziani, Prof Søren Jepsen (Germany), Prof Phoebus Madianos, and Prof Lior Shapira. Prof Maurizio Tonetti (Italy), editor of the Journal of Clinical Periodontology, joined them via videoconference.

The other experts from the IDF at the meeting were Dr Manu Mathur (India), Prof Ryan Demmer (United States), Dr Eduard Montanya (Spain), Dr Luca Lione (Italy), Dr Daniel Vegh (Hungary), and Prof Martin Buysschaert (Belgium). Representatives of Sunstar’s scientific and innovation strategy departments were also present at the workshop, along with members of the board of SEPA, the Spanish society of periodontology.


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