Blodsockermätning Vid Avancerad Parodontit; så Kan specialisttandvården Identifiera Hyperglykemi Och Bidra Till Individanpassad vård

Periodontitis is a chronic inflammatory disease affecting the supporting structures of the teeth and represents one of the most prevalent non-communicable diseases worldwide. Epidemiological studies show that population-level preventive strategies targeting dental biofilm control and smoking cessation have contributed to improvements in periodontal health, these measures have not resulted in a significant reduction in the prevalence of advanced periodontitis over the last decades. Individuals who develop severe and rapidly progressing periodontal disease have an increased susceptibility to plaque induced inflammation and hyperglycemia seem to play a central role as a modifyer of that susceptability.

A bidirectional relationship between hyperglycemia and periodontitis has been well established. Elevated blood glucose levels are associated with increased risk of periodontal tissue breakdown, impaired wound healing and accelerated disease progression, while periodontal inflammation may affect glycemic control. Hyperglycemia is therefore not only a systemic health concern but also a clinically relevant, modifiable risk factor that directly influences periodontal prognosis. Contemporary periodontal classification systems explicitly incorporate glycemic status into disease grading, emphasizing the importance of identifying and addressing this risk factor in patients with advanced disease.

Despite this recognized relationship, routine assessment of glycemic status is rarely performed in dental settings in Sweden, largely due to the absence of established protocols and access to point-of-care testing. This represents a missed opportunity, particularly within specialist periodontal care, where patients with Stage III and IV periodontitis are identified through comprehensive periodontal examinations. A substantial proportion of individuals with type 2 diabetes or prediabetes remain undiagnosed, and many of these individuals may seek dental care more regularly than medical care. Specialist periodontal clinics may therefore serve as a valuable setting for selective screening of hyperglycemia in a clearly defined high-risk population.

The present study aims to integrate capillary HbA1c testing as a routine in periodontal assessment within specialist dental care and to evaluate its ability to identify previously unrecognized hyperglycemia or suboptimal glycemic control as well as investigate the the patients and dentists experience of that routine. The study is designed as a cross-sectional observational investigation conducted at the Department of Periodontology, Eastman Institute, Stockholm, over a 12-month period.

Eligible participants are adult patients referred for evaluation and treatment of periodontitis who, following a full periodontal examination and radiographic assessment, are classified as having Stage III or Stage IV periodontitis according to current classification criteria. Patients who are unable to provide informed consent, have cognitive impairment or present with periodontitis as a manifestation of systemic disease or syndrome are excluded. To ensure informed participation, only patients able to understand written and spoken Swedish are included.