Periodontitis: A co-morbidity factor in diabetes mellitus. The implications for dentistry

Title: Periodontitis: A co-morbidity factor in diabetes mellitus. The implications for dentistry

Abstract:

In 1999 periodontal disease (PD) was thought to be the sixth complication of diabetes mellitus (DM) because this latter group of patients has a 3 - 4 times greater risk of developing PD when compared with non-diabetics. This rises to 10 times for smokers. More recent research has concluded that DM and PD are inter-related, one disease affecting the other and vice versa. The exact mechanism is probably related to inflammation as similar blood markers are raised in both diseases, the dental origin of which is from micro-organisms in mature dental plaque. From the medical point of view there are five complications of DM namely cardiac, vascular, renal, ophthalmic and neurological that can be visualised as a simple hub called DM with spokes for the above complications. However, the evidence has shown that the severity of all these five complications is worse when patients have active, uncontrolled PD. When PD is treated, there is an improvement in glycaemic control. Good oral hygiene is a critical component of glycaemic control. These results have led to the conclusion that both DM and PD should be hub diseases. Therefore, PD is not a separate complication of DM or spoke but a co-morbidity factor acting by:modifying the severity of another disease and modulating the severity of diabetic complications in the manner of a volume switch, a new model relationship. When DM and PD are treated together there may be a synergistic effect. A method of sharing results between doctors and dentists is proposed. Dentist have an important role to play in prevention. A method of effective and efficient control of interdental plaque will be presented.

Biography:

Dr Christopher Turner qualified from the Royal Dental Hospital of London with the degree of Bachelor of Dental Surgery with distinctions in 1968 and spent the first few years working in general practice before undertaking higher training in restorative dentistry in London and Newcastle upon Tyne. During this time, he passed the Fellowship in Dentistry examinations of the Royal College of Surgeons of England and gained his Master of Dental Surgery degree. In 1979,aged 34 years, he was appointed as a Consultant/Senior Lecturer in the University of Sheffield Dental School with the remit to establish new Department and a self-contained multi-surgery unit, separate from the School, for final year dental students to help them make the transition to qualified general practitioner. This was the first unit of its kind in the UK, has been copied and continues in the same building today. Then in 1984, he moved to an NHS appointment as Director of Dental Services in Salisbury. He took early retirement from the NHS in 2000 to establish a multidisciplinary private referral practice before retiring in 2012. He has always had an interest in prevention and plaque control and the links between diabetes mellitus and periodontitis, and is the inventor of the Chooseabrush® method to help patients with gingival recession optimise their oral health.