Does periodontal care improve glycemic control? The Department of Veterans Affairs Dental Diabetes Study.

Author(s): Jones JA, Miller DR, Wehler CJ, Rich SE, Krall-Kaye EA, McCoy LC, Christiansen CL, Rothendler JA, Garcia RI

Affiliation(s): VA Center for Health Quality, Outcomes and Economic Research, Bedford, MA, USA.

Publication date & source: 2007-01, J Clin Periodontol., 34(1):46-52. Epub 2006 Nov 24.

Publication type:

Objectives: Report results of a randomized-clinical trial of the efficacy of periodontal care in the improvement of glycemic control in 165 veterans with poorly controlled diabetes over 4 months. Methods: Outcomes were change in Haemoglobin A1c (HbA1c) in the Early Treatment versus untreated (Usual Care) groups and percent of participants with decreases in HbA1c. Analyses included simple/multiple variable linear/logistic regressions, adjusted for baseline HbA1c, age, and duration of diabetes. Results: Unadjusted analyses showed no differences between groups. After adjustment for baseline HbA1c, age, and diabetes duration, the mean absolute HbA1c change in the Early Treatment group was -0.65%versus-0.51% in the Usual Care group (p=0.47). Adjusted odds for improvement by 0.5% in the Early Treatment group was 1.67 (95% confidence interval: 0.84, 3.34, p=0.14). Usual Care subjects were twice as likely to increase insulin from baseline to 4 months (20%versus 11%, p=0.12) and less likely to decrease insulin (1%versus 6%, p=0.21) than Early Treatment subjects. Among insulin users at baseline, more increased insulin in the Usual Care group (40%versus 21%, p=0.06). Conclusions: No significant benefit was found for periodontal therapy after 4 months in this study; trends in some results were in favour of periodontal treatment.