Physical exercise is associated with improved periodontal health in type 2 diabetic patients

Schulze A2 , Busse M1

General Outpatient Ambulance1 and Sports Dentistry2 of the Institute of Sports Medicine & Prevention, University of Leipzig (1Director: Prof. M.W. Busse, MD) (2Head: A. Schulze, DDS)

Summary

Schulze A, Busse M. Physical exercise is associated with improved periodontal health in type 2 diabetic patients. Clinical Sports Medicine International (CSMI) 2009, 3: 5-10.

Purpose:Periodontal disease may induce immune responses which may contribute to coronary atherogenesis. Diabetes is associated with increased prevalence and severity of periodontal inflammations. Exercise training may improve diabetes therapy and the overall immune status. However, we are not aware of any studies which have looked for effects of physical exercise training on periodontal inflammation in diabetes.

Materials and methods:Fifty type 2 diabetic subjects were examined before and after a 7.1±3.2 months` recreational training program. The training consisted of sessions twice a week, each 45 min. A self-reported oral hygiene questionnaire was completed before and after the program. All subjects underwent a clinical periodontal examination including the gingivitis index (GI), papillary bleeding index (PBI), probing pocket depth (PPD), and periodontal screening and recording (PSR). Training and diabetes parameters were also measured.

Results:Endurance capacity was improved by 70%. There were no relevant changes in weight. HbA1c was decreased from 6,6±0,9 to 6,3±0,7. Oral hygiene was unchanged. The overall PSR was significantly decreased by 19%. The GI was significantly reduced to 62%, the PBI code 3 to 42% of pre-training values. The PPD of 5mm or 6mm was significantly reduced to 64% and 38% respectively.

Conclusion: A seven months moderate exercise training markedly improved endurance capacity and indices of periodontitis in type 2 diabetic patients. The latter effects are mainly attributed to an improvement of the systemic immune response due to exercise, but not to a major improvement of glycemic control. Another hypothesis is that an improvement of local blood flow reduces local gingival inflammation.

Keywords: Diabetes, periodontal disease, inflammation, physical exercise