The Diabetes/Dental Relationship

Dr. Lee Sheldon

Let’s introduce a term to you, “neutrophil chemotaxis.” The neutrophil is the white blood cell whose primary function is to engulf and kill bacteria in your bloodstream. Chemotaxis is the movement of a cell toward a chemical stimulant. In this case, bacteria send out a chemical. The neutrophil senses the chemical and moves toward the bacteria with the purpose of killing that bacteria. Neutrophil chemotaxis is therefore a primary function of your immune system. It protects you from infection.

Diabetes reduces neutrophil chemotaxis. The neutrophil doesn’t sense the bacteria. The bacteria can then grow unchecked. It is a primary reason why diabetics are more prone to infection.

How does this relate to dental treatment? When a patient’s diabetes is not under control, any dental surgical procedure can be riskier. In our practice, when one has a hemoglobin A1c of 8.3 or above, we choose to delay any elective surgical treatment until the patient has a lower A1c. Our goal is 7 or below. If one has an active infection in spite of an A1c of over 8.3, we of course will treat the infection.

Diet and medication are the primary methods of getting diabetes under control. However, an interesting study compared ten adults of an average age of 71 with younger controls, looking at, among other things, their neutrophil chemotaxis.* They did 60-90 second high-intensity workouts on a treadmill for 30 minutes three times a week. After ten weeks, the older patients’ neutrophil chemotaxis increased by 25%. Similar improvements occurred in other health markers

Medication is but one way to control disease. Working the body can result not only in improved fitness but in reducing your risk of infection.

*Bartlett et all, “Rejuvenation of Neutrophil…,” Front Immunol. 2020 May 5;11:729

Lee N. Sheldon, DMD
Solid Bite
2223 Sarno Road
Melbourne, Florida 32935