Will periodontal treatment result in improved glycemic control?
Review of the literature in answering the third question provides equivocal results. Two recent investigations provided evidence that treatment for periodontitis in type 2 diabetics resulted in an improvement in glycemic control. Both used glycated hemoglobin (HbA1c) as a measure of glycemic control, which measures the amount of glucose irreversibly bound to the hemoglobin molecule. The first study provided mechanical therapy to the test group and no periodontal therapy to the control group.46 After three months, the reduction in HbA1c was significantly greater for the test group than the control group, 21 percent vs. 9 percent. A second investigation combined ultrasonic scaling with systemic doxycycline and/or irrigation with water, chlorhexidine, or povidone-iodine.47 At three months, the test groups receiving doxycycline had significantly greater reductions in HbA1c that approached 10 percent. Those groups not receiving doxycycline had smaller and nonsignificant reductions in HbA1c.
