关于为何牙周炎应纳入糖尿病管理的当前科学证据。

Current scientific evidence for why periodontitis should be included in diabetes management.

作者信息

Borgnakke Wenche Sylling

机构信息

Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States.

Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, United States.

出版信息

Front Clin Diabetes Healthc. 2024 Jan 11;4:1257087. doi: 10.3389/fcdhc.2023.1257087. eCollection 2023.

Abstract

This Perspective provides a brief summary of the scientific evidence for the two-way links between periodontal diseases and hyperglycemia (diabetes mellitus [DM] and pre-DM). It delivers in a nutshell current scientific evidence for manifestations of hyperglycemia on periodontal health status and effects of periodontal diseases on blood glucose levels and in turn incidence, progression, and complications of diabetes. Of outmost importance is presentation of scientific evidence for the potential of routine periodontal treatment to lower blood glucose levels, providing a novel, economical tool in DM management. Non-surgical periodontal treatment ("deep cleaning") can be provided by dental hygienists or dentists in general dental offices, although severe cases should be referred to specialists. Such therapy can decrease the costs of DM care and other health care costs for people with DM. The great importance of a healthy oral cavity free of infection and subsequent inflammation - especially periodontitis that if untreated will cause loosening and eventually loss of affected teeth - has largely gone unnoticed by the medical community as the health care curricula are largely void of content regarding the bi-directional links between oral health and systemic health, despite elevation of blood glucose levels being an integral part of the general systemic inflammation response. The importance of keeping disease-free, natural teeth for proper biting and chewing, smiling, self-esteem, and pain avoidance cannot be overestimated. Medical and dental professionals are strongly encouraged to collaborate in patient-centered care for their mutual patients with - or at risk for - hyperglycemia.

摘要

本观点简要总结了牙周疾病与高血糖(糖尿病[DM]和糖尿病前期)之间双向联系的科学证据。它概括了目前关于高血糖对牙周健康状况的影响以及牙周疾病对血糖水平进而对糖尿病的发病率、进展和并发症的影响的科学证据。最重要的是展示了常规牙周治疗降低血糖水平的潜力的科学证据,为糖尿病管理提供了一种新颖、经济的工具。非手术牙周治疗(“深度清洁”)可由口腔保健员或普通牙科诊所的牙医提供,不过严重病例应转诊给专科医生。这种治疗可以降低糖尿病患者的糖尿病护理成本和其他医疗保健成本。一个没有感染及后续炎症的健康口腔——尤其是未经治疗会导致牙齿松动并最终脱落的牙周炎——的重要性在很大程度上未被医学界注意到,因为尽管血糖水平升高是全身炎症反应的一个组成部分,但医疗保健课程中很大程度上缺乏关于口腔健康与全身健康双向联系的内容。保持无病的天然牙齿对于正常咬合、咀嚼、微笑、自尊和避免疼痛的重要性再怎么强调也不为过。强烈鼓励医学和牙科专业人员为共同患有高血糖或有高血糖风险的患者开展以患者为中心的协作护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dec/10809181/7ddd2668da10/fcdhc-04-1257087-g001.jpg

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