It was truly disheartening to read the results of Dr. Carol Kunzel and colleagues’ August JADA article, "On the Primary Care Frontlines: The Role of the General Practitioner in Smoking-Cessation Activities and Diabetes Management" (
JADA 2005;136:1144–53[Abstract/Free Full Text]
). The authors documented a lack of mastery of knowledge and behavioral practices by active general dental practitioners in regard to involvement in screening and monitoring patients with diabetes.
Approximately 16 million Americans are believed to have diabetes, which, if not properly managed, can result in death from atherosclerotic disease (for example, myocardial infarction and stroke), renal failure and overwhelming sepsis.1,2 Diabetes is, however, one of the systemic illnesses whose control, in part, is dependent on proper dental treatment.
My colleagues and I3 have demonstrated that the removal of oral sites of infection (that is, treatment of periodontitis and removal of teeth with excessive alveolar bone loss or periapical infections, as well as oral hygiene instruction, full-mouth scaling, subgingival curettage and root planing) can result in a significant improvement (17 percent) in glycemic control.
These results are critically important because strict control of blood glucose levels has been shown to prevent, or mitigate, the numerous systemic complications associated with the disease.4 The primary care role of dentists certainly extends to monitoring those aspects of systemic illnesses for which our inventions have been shown to be helpful.
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