Effect of Structured Oral Hygiene Intervention on Glycemic Control in Diabetic Patients

Background: Periodontal disease is common among individuals with type 2 diabetes mellitus (T2DM) and is linked to poor glycemic control through systemic inflammation. Structured oral hygiene interventions may improve both oral and metabolic outcomes, yet evidence from standardized, behavior-based protocols remains limited. Objective: To evaluate the impact of a structured oral hygiene regimen on glycemic control and periodontal status in patients with T2DM through a multicentre randomized controlled trial. Methods: A total of 104 adults with T2DM and moderate to severe periodontitis were recruited from private hospitals in Lahore, Multan, and Islamabad. Participants were randomized equally into intervention and control groups. The intervention comprised personalized oral hygiene education, supervised training in the modified Bass brushing technique, provision of oral hygiene aids, and monthly reinforcement for six months. The control group received routine advice without structured reinforcement. Primary outcome was change in HbA1c measured by high-performance liquid chromatography. Secondary outcomes included Plaque Index, Gingival Index, Probing Pocket Depth, and Clinical Attachment Level, assessed by calibrated examiners at baseline, three months, and six months. Data were analyzed using independent t-tests and repeated measures ANOVA for normally distributed variables. Results: At six months, the intervention group showed a mean HbA1c reduction from 8.42 ± 0.56% to 7.58 ± 0.49% (p < 0.001), whereas the control group showed a non-significant change from 8.39 ± 0.59% to 8.28 ± 0.53%. Significant improvements were also observed in periodontal parameters in the intervention group (all p < 0.001), with negligible changes in the control group. Conclusion: Structured oral hygiene interventions significantly improved glycemic control and periodontal health in T2DM patients and should be considered a practical adjunct in comprehensive diabetes management.