reasoned Clark, although dental providers have long been On the dental side of the collaboration equation, getting aware of the bi-directional relationship between diabe- involved with the active management of diabetic patients tes and oral infections, the medical profession may not may be a stretch for some within dentistry. ² A study de-have understood this as well. The increased risk diabetic signed to investigate general dentists’ and periodontists’ patients have for periodontal disease and the effect of willingness toward assessment and management of the periodontal infection on glycemic control with the poten- patient with diabetes was conducted and recently report-tial for ratcheting up the risk for diabetic complications, ed by researchers from Columbia University. ² Analysis of has not been readily apparent to most within the medical the data from the small sample of practitioners who were community until recently. Clark cited the growing body of surveyed found that there is a need to increase periodon-related literature in both dental and medical journals as tists’ and general dentists’ involvement in the active man-significant in bringing about this increased level of aware- agement of the diabetic patient. ² ness of the ADA. In his own diabetes practice, Clark noted,

“As long as [diabetic patients] have ongoing infections in The commitment of the American Diabetes Association in
their mouths, their diabetes is very difficult to manage drafting more progressive protocols related to oral health
often leading to the need for more and more insulin.” in diabetes management is unprecedented. Undertaking
this level of progressive disease management has the

Clark reported that the Professional Practice Committee greatest potential to succeed in a delivery system that is of the ADA will soon be looking at what reasonable con- integrated and coordinated. We can only hope those on clusions may be drawn from the scientific evidence that the dental side will also embrace this as a valuable op-currently exists to support the bi-directional relationship portunity for collaboration. between diabetes and periodontal disease. Their scientific inquiry will also include looking at other oral com- References _{plications of diabetes such as xerostomia, dental caries,} 1. American Diabetes Association. Standards of Medical Care in

Diabetes-2006. Diabetes Care 2006; 29 (Suppl 1):S4-33.

^{candida infection, burning mouth syndrome, and lichen} 2. Kunzel C, Lalla E, Lamster IB. Management of the patient who
planus. According to Clark, plans to develop a consensus smokes and the diabetic patient in the dental office. J Periodontol
statement and care management guidelines may soon be ^{2006;77:331-340.}
underway.