Context and Aims
Research suggests that diabetes and oral health have a bi-directional relationship- that is diabetes increases the risk of poor oral health, which in turn can affect blood glucose levels. However, a complete synthesis of literature relating to oral health care and management of people with diabetes has not been undertaken. The aim of this scoping review was to synthesise the evidence on the link between diabetes and oral health, identify current guidelines and practices in this area, and explore the potential role of diabetes care providers in promoting oral health.
A literature search of eight databases was undertaken using a combination of keywords (diabetes mellitus/periodontal disease/oral health guideline/ non-dental professional/oral health promotion) and terms using Boolean operators, truncation, and Medical Subject Heading. After removal of duplicates and independent assessment by two authors, 50 papers published between 1946 and 2016 were selected.
There is general consensus that diabetes increases the risk of gum disease which can negatively affect blood glucose levels and increase diabetes related complications. Further, treatment of gum disease may improve blood glucose levels. Guidelines recommend that diabetes care providers should undertake oral health reviews of people with diabetes. However, to date no studies have explored how diabetes care providers can incorporate oral health into their practice and whether appropriate resources are available to assist them. Studies in other health care settings show that trained non-dental professionals can successfully provide oral health assessment, education and referrals to their patients.
Oral health care of people with diabetes is very important considering the two-way relationship. Diabetes care providers, such as Diabetes Nurse Educators could provide preventive oral health services. Further research is required in this area to explore the feasibility and acceptability of preventive oral health services in the diabetes care framework.