Diabetes is an interdisciplinary disease, which means that it should be de alt with by doctors of many speci alties, not only diabetologists. And so it is. They take care of the diabetic patient, among others. cardiologists, nephrologists, neurologists, orthopedists. Now they are joined by… dentists. When does a dentist help detect diabetes? We talk to prof. dr hab. n. med. Leszek Czupryniak, head of the Department of Internal Diseases and Diabetology of the Medical University of Warsaw.
Dentists can make a significant contribution to finding out about diabetes. Diseases of the teeth and mouth in people with diabetes are very common. People with diabetes have significantly fewer teeth than he althy people. People aged 60-70 should have at least ten of their own teeth, while very few diabetics can "boast" of this result. In addition, oral lesions in patients with diabetes, such as tooth decay or gingivitis, progress faster. Healing processes are also more difficult in such cases. The susceptibility to infections and fungal lesions clearly increases. And finally; diabetes has a negative impact on implant placement, it can cause many serious changes in the oral mucosa.
A few years ago, we conducted a study evaluating the condition of the dentition of over 2.5 thousand children. diabetics. It turned out that they had significantly fewer teeth than a properly selected control group without this disease. And this gave us the idea of cooperation between dentists and diabetologists. The current coalition is therefore a continuation of the previous project.
The coalition is already running. Its partners are the Polish Diabetes Society, the Polish Dental Society and the TEVA company. Over 500 already take part in itdentists. Each of them will receive 20 referrals for blood sugar testing of their patients. Referrals will be made to those patients who are at real risk of diabetes. We have prepared a specific protocol for the dentists participating in the project, allowing the patient to be qualified. Suspicion of diabetes is to suggest not only the condition of the oral cavity, but also overweight or obesity, over 45 years of age, and diabetes in the immediate family. And if the patient has at least one of these factors, they will be referred for a blood sugar test. We have prepared 50 thousand such referrals.
This is e.g. a fungal infection in the corners of the mouth, a pale, less vascularized tongue, dry mouth, rapidly progressing cavities, exposed necks, advanced caries.
Because diabetes does not give any symptoms for a long time. Late diagnosis of diabetes is a common problem. Even in the countries that can boast the best results, around 25 percent. cases of diabetes mellitus remain unrecognizable for a long time. And it happens despite good, even very good basic he alth care and proper research system. About 3 million people in Poland suffer from diabetes, but over half a million are not aware of the disease. It is worth adding that more than twice as much is pre-diabetic, but she is not aware of it yet.
That's it. And certainly once a year blood sugar testing should mean: overweight people, i.e. with a BMI equal to and above 25 kg / m2 , with family history of diabetes, low physical activity, hypertension, hyperlipidemia, polycystic ovary syndrome, diseases of the cardiovascular system, history of diabetes in pregnancy, giving birth to a child weighing more than 4 kg.
Better diabetes detection. And once again, I appeal to dentists not to focus solely on the activities that are part of their speci alty, but not to ignore those symptoms in their patients that may indicate a different disease. In this case - diabetes. And I emphasize: the point is not to replace family doctors, but onlyto help them make a correct diagnosis.