Diabetes and Dental Screening New Delhi, August 16, 2016: Periodontal or gum disease is a common complication of diabetes and itself contributes to poor glycemic control, said Padma Shri Awardee Dr KK Aggarwal – President Heart Care Foundation of India (HCFI) and Honorary Secretary General IMA. Severe periodontal disease has been shown to be an independent risk factor for mortality from ischemic heart disease and nephropathy. Annual dental examination is recommended in both dentate and non–dentate diabetic patients. In diabetics, control of the blood sugar is the key. If uncontrolled, one carries a higher risk of 1. Tooth decay (cavities). The mouth naturally contains many types of bacteria. The higher the blood sugar level, the greater the supply of sugars and starches — and the more acid damages the teeth. 2. Early gum disease (gingivitis). Diabetes reduces the ability to fight bacteria, which can cause more plaque to build up on the teeth. 3. Advanced gum disease (periodontitis). Left untreated, gingivitis can lead to a more serious infection called periodontitis, which destroys the soft tissue and bone that support the teeth. Periodontitis tends to be more severe among people who have diabetes because diabetes lowers the ability to resist infection and slows healing. 4. Patients with diabetes mellitus should also receive influenza flu vaccination yearly and pneumococcal vaccination. The pneumococcal vaccine should be repeated once after 65 years of age if the initial vaccination was prior to this age. 5. Tetanus and diphtheria vaccinations should also be updated. 6. Diabetes is considered equivalent to known coronary disease in predicting the risk of future cardiac events. Smoking cessation is essential for patients who smoke. Cardiovascular morbidity can also be significantly reduced with aggressive management of hypertension (goal blood pressure less than 120/80 mmHg), cholesterol (goal LDL less than 80 mg/dL) and use of aspirin (80 mg/day) in patients over age 40 years, and in younger patients with additional cardiovascular risk factors. 7. Aspirin alone may not be the answer as a Japanese research has shown that low-dose aspirin does not reduce the risk of cardiovascular events in people with type 2 diabetes.