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May 23, 2016

Diabetes detected by... a dentist?

A Michigan State University diabetes expert and a local dentist have teamed up to create a screening tool that dental offices can offer patients to determine their risk for diabetes.

Saleh Aldasouqi, an associate professor of medicine and chief of endocrinology at Michigan State University, and Susan Maples, a family dentist in Holt, Michigan, are working together to educate patients on how diabetes can influence gum disease, as well as help other dentists and dental hygienists around the country recognize what diabetes looks like in the mouth.

There is documented evidence that says diabetes significantly worsens gum disease and bone loss around teeth, and active gum disease impairs the patient's ability to get blood sugar levels under control.

The Centers for Disease Control and Prevention estimates that one in three American adults will be diabetic by 2050.

Aldasouqi said studies have shown that more than two thirds of people in America visit their dentist at least once a year, many of whom do not see their regular doctor.

“In other words, there’s an opportunity for patients in the dental clinics to be screened for diseases,” Aldasouqi said. “Diabetes and prediabetes are a very difficult public health problem.”

Maples said she would like to influence dentists across the country to start screening for diabetes and help stop the deteriorating health of America. By doing this, it may also help prevent gum disease.

As a result, Maples and Aldasouqi created a screening tool that did not include weighing patients on a scale or even discussing the patient's weight in order to determine a body mass index measurement. It's well documented that being overweight or obese is a leading risk factor for type 2 diabetes, yet Maples thought patient compliance to step on a scale at a dentist office would be low.

The tool, Diabetes Detection in the Dental Office, or DiDDO Score, is a 14-question survey that requires no body weighing, BMI calculation, laboratory tests or blood pressure measurement. It allows dentists to identify patients at moderate and high risk for diabetes mellitus and prediabetes.

To conduct the study and test the screening tool, 500 dental patients, age 18 years or older, without history of diabetes mellitus and or prediabetes, completed the questionnaire and received finger pricks to measure their A1c, the sugar in their hemoglobin.

After testing the blood, the results were measured against the positive responses of the questionnaire in order to find a screening tool that would be validated or easily used in a dental office.

"The results were astonishing,” Aldasouqi said. “About 19 percent of those patients had prediabetes and they didn’t know it.”

Maples said the screening tool not only helps identify risk factors, but educates patients to recognize symptoms of diabetes.

“You might have a loved one that has those same symptoms, or years from now say ‘I’m getting tingling and numbness in my hands and feet. I wonder if that’s diabetes,’” Maples said. “You can understand what the disease is and have a discussion about the effects of it.”

She said that when a patient has diabetes and gum disease, the last thing that should be done is to treat the gum disease in a normal surgical way. According to the U.S. National Library of Medicine, diabetes may increase risk for problems during or after surgery, such as infection or slower healing.

“Introducing a small wound in a diabetic, in which you are pouring negative bacteria, is not a good thing,” Maples said.

Aldasouqi and Maples’ goal is for a larger study to be conducted, for the screening tool to be offered in every dental office in America and to detect diabetes as soon as possible.

Aldasouqi said his role has been and will continue to be to collaborate with the dental scientific community to help implement the tool. Maples’ role is to reach out to dental organizations throughout the nation so that the tool becomes a standard.

The study can be found in the Journal of Diabetes Mellitus.