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An umbrella review of systematic reviews examining the relationship between type 2 diabetes and periodontitis: Position paper from the Canadian Dental Hygienists Association.

ABSTRACT: Previous research has confirmed strong associations between periodontitis and diabetes mellitus (DM), supporting DM as a risk factor for periodontal disease and suggesting a bidirectional relationship. Causal relationships have not been confirmed.

Aim

The aim of this paper is to review the most current evidence of the nature of this relationship and examine whether non-surgical periodontal therapy (NSPT) significantly lowers glycemic (HbA1c) control.

Methods

The PICO question was, "For individuals with type 2 diabetes mellitus (T2DM) and periodontitis, will non-surgical periodontal therapy (NSPT), as compared to no treatment, improve the individual's glycemic control as measured by HbA1c." Only systematic reviews (SRs) with or without a meta-analysis (MA) of randomized controlled trials (RCTs) or umbrella reviews of SRs and MAs of RCTs published in the English language between 2007 and 2019 were included. Several databases were searched as per their protocols. Quality assessments were conducted by both authors using the PRISMA checklist. The Bradford Hill criteria were used to determine evidence for causality.

Results

Of 54 records retrieved, after elimination of duplicates and studies not meeting inclusion criteria, 5 SRs/MAs and 3 umbrella reviews of SRs/MAs were selected. All 5 SRs/MAs reported reductions in HbA1c levels 3 months following NSPT, but effect sizes were small and 2 were not statistically significant. The 3 umbrella reviews consistently reported small reductions in HbA1c, but high levels of heterogeneity and moderate to high risk of bias. The Bradford Hill criteria failed to support a causal relationship between periodontitis and T2DM.

Conclusions

Whether NSPT compared with no treatment in persons with T2DM improves the individual HbA1c remains unclear as does the exact nature of the relationship between periodontitis and T2DM.

SUBMITTER: Lavigne SE

PROVIDER: S-EPMC7906119 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

An umbrella review of systematic reviews examining the relationship between type 2 diabetes and periodontitis: Position paper from the Canadian Dental Hygienists Association.

Lavigne Salme E SE Forrest Jane L JL

Canadian journal of dental hygiene : CJDH = Journal canadien de l'hygiene dentaire : JCHD 20210215 1

Previous research has confirmed strong associations between periodontitis and diabetes mellitus (DM), supporting DM as a risk factor for periodontal disease and suggesting a bidirectional relationship. Causal relationships have not been confirmed.<h4>Aim</h4>The aim of this paper is to review the most current evidence of the nature of this relationship and examine whether non-surgical periodontal therapy (NSPT) significantly lowers glycemic (HbA1c) control.<h4>Methods</h4>The PICO question was, ...[more]

PMID: 33643418

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Project description:BackgroundSince the outbreak of COVID-19, how to reduce the risk of spreading viruses and other microorganisms while performing aerosolgenerating procedures (AGPs) has become a challenging question within the dental and dental hygiene communities. The purpose of this position paper is to summarize the evidence of the effectiveness of various mitigation methods used to reduce the risk of infection transmission during AGPs in dentistry.MethodsThe authors searched 6 databases-MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Library, and Google Scholar-for relevant scientific evidence published between January 2012 and December 2022 to answer 6 research questions about the risk of transmission, methods, devices, and personal protective equipment (PPE) used to reduce contact with microbial pathogens and limit the spread of aerosols.ResultsA total of 78 studies fulfilled the eligibility criteria. The literature on the risk of infection transmission including SARS-CoV-2 between dental hygienists and their patients is limited. Although several mouthrinses are effective in reducing bacterial contaminations in aerosols, their effectiveness against SARS-CoV-2 is also limited. The combined use of eyewear, masks, and face shields is effective in preventing contamination of the facial and nasal region while performing AGPs. High-volume evacuation with or without an intraoral suction, low-volume evacuation, saliva ejector, and rubber dam (when appropriate) have shown effectiveness in reducing aerosol transmission beyond the generation site. Finally, the appropriate combination of ventilation and filtration in dental operatories is effective in limiting the spread of aerosols.Discussion and conclusionAerosols produced during clinical procedures can pose a risk of infection transmission between dental hygienists and their patients. The implementation of practices supported by available evidence will ensure greater patient and provider safety in oral health settings. More studies in oral health clinical environments would shape future practices and protocols, ultimately to ensure the delivery of safe clinical care.

Dataset Information

An umbrella review of systematic reviews examining the relationship between type 2 diabetes and periodontitis: Position paper from the Canadian Dental Hygienists Association.

Aim

Methods

Results

Conclusions

Publications

An umbrella review of systematic reviews examining the relationship between type 2 diabetes and periodontitis: Position paper from the Canadian Dental Hygienists Association.

Similar Datasets

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