From dental chair to diabetes care: Patient experience highlights potential of new screening pathway

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  • University of Birmingham
  • University Hospitals Birmingham NHS Foundation Trust
  • Birmingham Women’s and Children’s Hospitals NHS Foundation Trust
  • Aston University
  • The Royal Orthopaedic Hospital NHS Foundation Trust
  • Sandwell and West Birmingham Hospitals NHS Trust
  • Health Innovation West Midlands
  • Birmingham and Solihull Mental Health NHS Foundation Trust
  • Birmingham Community Healthcare NHS Foundation Trust

About INDICATE

In a study published in 2023, the research group at the University of Birmingham comprising Dr Zehra Yonel and Professors Iain Chapple and Thomas Dietrich teamed up with Professor Laura Gray from the University of Leicester to develop a new score called the Diabetes risk assessment in Dentistry Score (DDS), for use by dental teams to detect pre-diabetes and diabetes in dental settings.

As part of a recent pilot study called INDICATE, funded by NIHR and Diabetes UK, the DDS was used in conjunction with a finger-prick test for diabetes, called the HbA1c test. The INDICATE trial, which engaged 13 dental practices and 805 dental patients, found that almost 15% of people walking through dental practice doors perceiving themselves to be healthy, exceeded UK pre-diabetes / diabetes thresholds (≥ 42mmol/mol HbA1c).

About the NIHR

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

• Funding high-quality, timely research that benefits the NHS, public health and social care;
• Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
• Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
• Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
• Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
• Funding applied global health research and training to meet the needs of the poorest people in low and middle-income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low and middle-income countries is principally funded through UK international development funding from the UK government.

The National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre translates new scientific discoveries into treatments and diagnostics to improve people’s health in the UK and across the globe. We focus on inflammation, a common feature of many diseases, and work to improve its diagnosis, prevention and treatment. We are part of the NIHR and hosted by University Hospitals Birmingham NHS Foundation Trust in partnership with the University of Birmingham.

About Haleon

Haleon (LSE / NYSE: HLN) is a global leader in consumer health, with a purpose to deliver better everyday health with humanity. Haleon’s product portfolio spans five major categories – Oral Health, Pain Relief, Respiratory Health, Digestive Health and Other, and Vitamins, Minerals and Supplements (VMS). Its long-standing brands – such as Sensodyne, Panadol, Otrivin, Polident, Corsodyl and Centrum – are built on trusted science, innovation and deep human understanding.

About diabetes and the strong link with periodontitis

Diabetes is one of the most common chronic conditions in Europe. At least 64 million adults and around 300 000 children and adolescents are estimated to be living with diabetes in the WHO European Region.

Some types of diabetes can be prevented by targeting risk factors with interventions such as improving nutrition, increasing physical activity, reducing obesity, reducing tobacco use and providing more health-supporting environments.

If diabetes is not diagnosed and managed correctly, life-threatening acute events such as comas can occur, as well as progressive disability from complications of the condition. Important complications of diabetes include blindness from damage to blood vessels in the eye, ulcers, amputations from nerve damage in the feet, and kidney disease. The risk of heart attack and stroke increases up to 4-fold for people living with diabetes.

There is a strong link between diabetes and severe gum disease (periodontitis) which has been highlighted by world leading authorities such as the International Diabetes Federation[6], National Institute for Health and Care Excellence (NICE), the World Organisation of National Colleges of Family Doctors, the European Federation of Periodontology, the Federal Dentaire Internationale (FDI) and many others.

The relationship between periodontal (gum) health and diabetes control and complications is bi-directional – if gum disease gets worse, it can make diabetes harder to control and lead to more complications. On the flip side, if diabetes is not well-managed, it can exaggerate gum inflammation and make it harder to treat.

Periodontitis is often associated with living in more socioeconomically deprived areas, as a result of less stringent oral care routines and less frequent attendance at preventative dental check ups.