Periodontitis, Adult, Prediabetes / Type 2 Diabetes
Conditions
Brief summary
This study will evaluate whether HbA1c screening can be performed in dental care to detect elevated blood glucose in patients with advanced periodontitis and support referral to primary care. Periodontitis is a common chronic inflammatory disease affecting the supporting tissues of the teeth. Advanced periodontitis is associated with prediabetes, type 2 diabetes and cardiovascular disease. The relationship between periodontitis and diabetes is bidirectional: diabetes increases the risk and severity of periodontitis, while periodontal inflammation may contribute to impaired glucose regulation. Patients with advanced periodontitis may therefore represent a group at increased risk of undetected elevated blood glucose. Many of these patients visit dental care regularly but may not otherwise be reached by structured medical prevention. This is a cross-sectional observational feasibility study conducted in public dental clinics in Skåne, Sweden, in collaboration with primary care. Adult patients aged 18 years or older with advanced periodontitis, defined as periodontitis stage 3-4 or grade B/C, will be invited to participate during a routine dental visit. Patients with previously diagnosed diabetes will not be included. After informed consent, participants will complete or update a health declaration and undergo capillary HbA1c testing at the dental clinic using a validated point-of-care instrument. Participants will receive their test result. Those with HbA1c ≥42 mmol/mol will receive standardized information and be referred to their listed primary care centre for further diagnostic assessment and preventive follow-up according to routine clinical practice. The study will assess how feasible this pathway is in routine dental care. Outcomes include participation rate, successful HbA1c testing, time required for study procedures, prevalence of elevated HbA1c, proportion referred to primary care, completed primary care follow-up within six months, dropout and costs. Follow-up data will be collected from medical records and regional registers. The study may provide a practical model for collaboration between dental care and primary care, with the long-term aim of improving early detection of prediabetes and diabetes and strengthening preventive care for patients with advanced periodontitis.
Interventions
DIAGNOSTIC_TESTPoint-of-care HbA1c screening
All participants undergo capillary HbA1c testing at the dental clinic using a validated point-of-care instrument. Test results are provided to the participant during the visit.
OTHERConditional standardized primary care referral
Participants with HbA1c ≥42 mmol/mol receive standardized information about the elevated test result and are referred to their listed primary care centre for further diagnostic assessment and preventive follow-up according to routine clinical practice.
Sponsors
Region Skane
Folktandvården Skåne AB
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 18 years or older. * Advanced periodontitis, defined as stage 3-4 periodontitis or grade B/C periodontitis according to clinical and radiographic assessment during routine dental care. * Ability to understand study information and provide informed consent.
Exclusion criteria
* Previously diagnosed diabetes mellitus. * Inability to provide informed consent, for example due to severe mental disorder or markedly impaired health status as judged by the clinical staff.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Participation rate | 6 months | Number of participants included out of those who meet the inclusion criteria. Reasons for non-participation will be recorded in free text. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of participants with HbA1c 42 mmol/mol or higher. | 6 months | Proportion of participants with HbA1c 42 mmol/mol or higher |
| Proportion of patients undergoing blood pressure examination at follow-up in primary care | 6 months | Through review of medical records at the patient's primary health care center, assessment of proportion of patients undergoing blood pressure examination. |
| Proportion of patients undergoing blood lipid laboratory samples | 6 months | Through review of medical records in primary care, assessment of proportion of patients undergoing blood lipid laboratory sample. |
| Diagnosis at follow-up | 6 months | Diagnosis registered at the follow-up in primary care |
| Proportion of patients receiving lifestyle advice at follow-up | 6 months | Through review of medical records at follow-up in primary care, assessment of proportion of patients receiving advice on lifestyle habits. |
Countries
Sweden
Contacts
CONTACTSusanna Calling
CONTACTPeter Nymberg
Outcome results
None listed