Oral health is a window to general health

Patients with diabetes often have poor oral health. Hasaan Mohamed is the first researcher to investigate this connection among diabetes patients in Sudan.

Hasaan Mohamed
A SIGNIFICANT CONNECTION: Hasaan Mohamed has examined the connection between the oral health and the general health of diabetes patients in Sudan.
Elin Espe Stensvand

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Why did you want to take a PhD?

“After finishing my studies, I worked purely as a clinician for two and a half years back in Sudan. I was also a teaching assistant at the University of Khartoum. However, there is very little research in this field in Sudan, so I decided to apply for an academic degree. I got the chance at the University of Bergen (UiB), and was very happy with that. The collaboration between the University of Khartoum and UiB is very strong and very active, so it was surprisingly easy to get connected and find a professor willing to supervise me.”

Why did you choose the topic oral health and diabetes in Sudan?

“First of all there is no published data about the oral health status among diabetic patients in Sudan. The University of Bergen gave me the chance to look at this problem for the very first time, and document it, as a base for further research, investigation, and interventions among this specific sector of the society. While working at the clinic, I noticed that patients with diabetes had poor oral health, but they did not have any special kind of consideration for their medical situation. Therefore, I decided to go into this field to get some insight and help them get some attention. And we got some very interesting results.“

How did you approach your work?

“I went to Sudan for almost nine months to collect data. When I first contacted the centre for diabetic patients there was no dental clinic. Rather, there was a dental clinic, but it was only used for storage. There was a dental chair and all of the equipment, but it was all dusty. I was annoyed, thinking; “They have the facilities, so why are they not using them?” I contacted the manager and asked him if I could use the clinic for data collection. He said that I could just clean it and use it. “

What happened next?

“I cleaned it all up, and I also obviously brought some equipment with me. After working there for four months, collecting data in the diabetic centre, the manager noticed that people were in need of a dentist in the centre, so now it is a working dental clinic. Actually I am so happy with only this part alone, apart from the research I did; people got to know that it is important for diabetic patients to have special dental care.”

What is the link between oral health and general health?

“The mouth is the mirror of the body, so my results showed that having good oral health helps maintain metabolic control, or putting it simply, a balanced blood glucose level. And it is vice versa, it is a bidirectional relationship, so those with poor glycaemic control, or high levels of glucose in their blood, also have poor oral health as a consequence.

You write that since dental workers see their patients regularly, they may contribute to discovering diabetes at an early stage. Can you explain this?

“This is important. I studied some inflammatory markers in an oral fluid that is secreted in the gum area, around the teeth. Nowadays it is a hot topic that if we analyse specific markers in this fluid, it can reflect the diabetic status, or the inflammatory status, as a diagnostic marker. I measured a lot of inflammatory markers in this fluid, like insulin, glucagon and other hormones related to diabetes. This is one step towards the dentist being able to diagnose undiagnosed diabetes cases. Worldwide, the undiagnosed diabetes cases are 44 per cent! The oral condition is considered one of the early signs of diabetes, so I believe that we can somehow use this to diagnose diabetes in the future.”

What has it been like, being a PhD student at UiB?

“Being a PhD student is not an easy job, because you have limited time and budget, and it can get really stressful. At times, I would be working 12 hours a day. But after finishing, I am really happy and joyful. Worldwide there are about 300 million people suffering from diabetes. It is important to help them live as normally as possible. If I can make a small contribution to that, I will be very grateful.”

What are your dreams for your future career?

“I would like to continue with teaching and clinical research in addition to the clinical practice, and my future plan is to focus on oral health and inflammation among medically compromised patients; especially those with diabetes. My aim is to develop and apply my clinical and research experience to serve this group of the society. I hope by that by ten years’ time I could have my own research group and a well-equipped lab facility.”