Who cares if bleeding gums worsen diabetes and heart disease?

This blog has been written by UCL Centre for Co-Production in Health Research Pilot Team Members – Heather, Ian, Brian and Francesco

Everyone’s gums bleed, right?

So what’s the deal? Well, for most people bleeding means gum problems and in around half could affect smiling and chewing by damaging the bone around the teeth and causing the gum line to shrink up. You can prevent it with coaching in self-care from your dental team. Once it has taken hold it is very treatable in the early stages.

Your mouth is connected to your body and the connection works both ways, particularly in diabetes

It is now clear that gum disease can worsen diabetes health and increase the risk of complications including heart disease. In the opposite direction, diabetes can worsen gum disease. New research has just been published in The Lancet, from University College London, Eastman Dental Institute led by Francesco D’Aiuto. The results show that intensive treatment of gum health can improve blood sugar levels in diabetes and reduce the risk of heart disease. Remarkably, the effect is similar to diabetes medicines. It seems to work by reducing the inflammation in the body that is caused by the bacteria in severe gum disease.

Lead researcher, Francesco D’Aiuto said:

‘Around 4 million people are living with diabetes in the UK the number is rising rapidly. Half of the population have some form of a gum condition which could affect their diabetes. Making it easier for people to have better control of their diabetes health is powerful and could also save our NHS millions of pounds. We are excited by the research results and now need to test how well it works in the community’.

We need to work together to design better research: Co-pro

The next stage of research will test how well the treatment works when given in the same way as could be rolled out across the country. However, it is extremely difficult to get the design of the research right and health professionals will have very different opinions from people living diabetes. So, we have set things up differently, as a co-production. This means that our planning team includes patients, members of the community, diabetes and cardiovascular health professionals, gum health professionals and clinical trial statisticians. Co-production means that we make decisions together.

Brain Potter commented:

‘As a member of the public and part of this team, it is important to me that health researchers look at the effect of the teeth and gums on peoples’ health. They must affect each other in some way. I hope this research will get people thinking about how they can work together across different health areas’.

This is a new approach to research design and we are also learning how best to do it. What is extremely helpful is the support from the University College London, Centre for Co-Production in Health Research and it’s fair to say that we are all learning together.

Heather Johnson a councillor with Camden, one of the team said:

‘As someone with diabetes, I think this is an exciting project to work with. Local community members like me have an important part in bringing in the views of the community and especially those with diabetes’.

Come and join us on 19 November

Please join us for some food and an informal meeting to discuss the research at The Living Centre, 2 Ossulston Street, London NW1 1DF near Kings Cross station, 19 November, 3.00-5.00pm (we are happy refund your travel expenses). We would welcome a broad range of ideas to help with the project including from people living with diabetes, GPs, diabetes nurses, pharmacists, dentists, hygienists and health and social support workers. To get you started, these are just some of the issues that we have identified as particularly important. You may have further ideas:

1. How can we recruit people with gum disease to the study from diabetes clinics and GP practices?
2. What would encourage people with diabetes to seek gum treatment in the study?
3. What would help people in the study to keep up their daily gum care and to come back for follow-up visits over the two years of the project?
4. What type of care should we compare the people receiving the gum treatment with? What is routine or community care for gum health?
If you are thinking of coming please let our project coordinator know if you would like to take part: l.hakobyan@ucl.ac.uk.

We look forward to seeing you on 19 November!

Heather Johnson, Camden Council
Ian Needleman, University College London, Eastman Dental Institute
Brian Potter, Islington Leaseholders Association
Francesco D’Aiuto, University College London, Eastman Dental Institute