Diabetes - Long Term Care

Diabetes : 

Diabetes Glucose management affected by oral health

Slide 2: 

“ Analysis indicated that periodontal care appeared to have a positive effect on the cost of medical care … Members with periodontal treatment also had lower retrospective risk for their chronic condition (diabetes, CAD, CVD). ” -Mary Lee Conicella , DMD, FAGD, National Director of Clinical Operations for Aetna Dental.

Slide 3: 

Older , more diverse population and longer lifespans contribute to increase. www.cdc.gov/media/pressrel/2010/r101022.html 2-3X

Slide 4: 

Among U.S. residents aged 65 years and older, 10.9 million, or 26.9%, had diabetes in 2010. 27 %

Pre Diabetes in Adults: 

Pre Diabetes in Adults 50 % of adults aged 65 years or older had pre-diabetes 50 %

The Big Five Six: 

The Big Five Six

The Sixth Complication: 

The Sixth Complication Periodontal Disease

Diabetes has an effect on the microvasculature: 

Diabetes has an effect on the microvasculature

Gums are filled with microvasculature: 

Gums are filled with microvasculature

Diabetic Wounds are hard to heal: 

Diabetic Wounds are hard to heal The damage to the capillary vessels is one reason.

Periodontal Disease Surface Area: 

Periodontal Disease Surface Area

Slide 13: 

The hand as a percentage of Whole body by shape 2.5% for the lean group 2.3% for overweight people Journal of PHYSIOLOGICAL ANTHROPOLOGY Vol . 26 (2007)

Slide 14: 

Image courtesy of Patterson Technology

200 cm2 chronic wound: 

200 cm 2 chronic wound 1% total surface area of the human body Invisible Painless No fever Image from: www.burnexperts.com/burnseverity.htm

Christopher Reeves: 

Christopher Reeves Died of “bed sore”

Periodontal Treatment improved Glycemic Control: 

Periodontal Treatment improved Glycemic Control The effect of periodontal therapy on the improvement of glycemic control in patients with type 2 diabetes mellitus: A randomized controlled clinical trial . Int J Diabetes Dev Ctries . 2008

Periodontal Treatment improved Glycemic Control: 

Periodontal Treatment improved Glycemic Control Effect of non-surgical periodontal therapy on patients with type 2 diabetes mellitus. Folia Med (Plovdiv). 2007

Slide 19: 

Decay Periodontal disease Oral Cancer Self esteem Social interactions Dry mouth Pain Chewing Speaking Function Symptoms Esthetics Pathology

Slide 20: 

The relationship between perceived chewing ability and oral health-related quality of life status in partially dentate patients attending a prosthodontic clinic is significant, and this relationship is likely influenced by denture status and nonclinical characteristics. Therefore , perceived chewing ability appears to be an important component of perceived oral health. www.hqlo.com/content/pdf/1477-7525-8-118.pdf

Slide 21: 

One third of all elderly have “ difficulty chewing or biting some foods ” 20+ teeth needed for good nutrition

Periodontal Treatment improved Glycemic Control: 

Periodontal Treatment improved Glycemic Control Effect of non-surgical periodontal therapy on glycemic control in patients with type 2 diabetes mellitus. J Periodontol . Sep;74(9) 2003

Slide 23: 

Full-mouth tooth extraction resulted in an improvement in glycemic control among diabetic patients. J Periodontal Res. 2010 Dec;45(6)

Blood Sugar and Exercise: 

Blood Sugar and Exercise 1,154 people entered their BG numbers on BigBlueTest.org (you can enter your numbers any time you want, even if it's not World Diabetes Day!)

Is exercise a nutrient?: 

Is exercise a nutrient?

The Oral Systemic Link: 

The Oral Systemic Link “ The review of oral health linkages with general health reveals implications for the clinical practice of both medicine and dentistry. The recognition of well known and established signs and symptoms of oral diseases may assist in the early diagnosis and prompt treatment of some systemic diseases and disorders. ”

Saves everyone!: 

Saves everyone!

Insurance saves money!: 

Insurance saves money! 3 year study 3500 people with diabetes Periodontal Treatment Saved $2,483 in medical costs Per Year

$2,483: 

$2,483 B y managing the risk, each person with diabetes saved over $2K in other medical expenses per year! Research from CIGNA Supports Potential Association between Treated Gum Disease and Reduced Medical Costs for People with Diabetes

To Summarize: 

To Summarize

Conclusion: 

Conclusion Dental hygienists cannot work in Long Term Care facilities unless there is also a dentist there to “oversee” them. Dental hygienists risk their license if they brush someone’s teeth without a prescription by a dentist to do so.

Slide 33: 

Find out the laws restricting dental hygienists in your state! Mandating a dental hygienist on the staff of all Medicaid funded care facilities can save millions of dollars a year just in people with diabetes.

Credits: 

Credits PowerPoint designed by Cross Link Presentations, LLC Presentation design Shirley Gutkowski, RDH, BSDH, FACE crosslinkpresent@aol.com Script Shirley Gutkowski, RDH, BSDH, FACE Photos: Dreamstime , Gutkowski, Stone Characters: PresenterMedia Copyright 2011 Exploring Transitions, LLC