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Heydari MH, Sharifi F, Sobhaninejad S, Sharifi A, Alizadeh L, Darmiani S, Bijari S, Parvaie P, Bakhshandeh S, Shoaee S, Khoshnevisan MH. The association between dental caries, periodontal diseases, and tooth loss with diabetes mellitus among the elderly population. J Diabetes Metab Disord 2024; 23:1371-1380. [PMID: 38932804 PMCID: PMC11196431 DOI: 10.1007/s40200-024-01434-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/10/2024] [Indexed: 06/28/2024]
Abstract
Purpose Our study investigated the association between dental caries, periodontal diseases, and tooth loss with diabetes mellitus (DM) among the elderly population, representing the first study of its kind in Iran. Methods This was a cross-sectional community-based study as a part of the second wave of the Birjand longitudinal aging study (BLAS, 2021-2022) for people older than 60. We used the Comprehensive Geriatric Oral Health Assessment Tool (CGOHAT) for the oral health evaluation. Participants were initially categorized into diabetic and non-diabetic groups. Those patients with DM were further categorised into uncontrolled and controlled diabetes based on their HbA1c level. The association between periodontitis, gingivitis, and edentulism with type II diabetes mellitus and uncontrolled diabetes was assessed using logistic regression. Results Among the 1,011 participants, 324 (32.04%) had DM. The mean ± SD DMFT was 27.06 ± 7.71 and 27.07 ± 7.72 among those with and without DM, respectively (p = 0.976). The M index comprised 85.46% of the total DMFT among those without DM and 84.51% among those with DM. The prevalence of periodontitis was higher among those without DM (110, 32.84%, p = 0.390). The prevalence of gingivitis was higher among those with DM (73, 45.06%, p = 0.617). Among the diabetic group, 137 (42.28%) had controlled DM. Based on the adjusted matched multivariate logistic model, decayed teeth (1.24, 95%CI: 1.06 - 1.46, p-value = 0.006), periodontitis (2.78, 95%CI: 1.02 - 7.56, p-value = 0.044), and moderate tooth loss (5.73, 95%CI: 1.13 - 28.88, p-value = 0.034) were significantly associated with increased odds of uncontrolled DM. Conclusions Based on the findings of this study, tooth loss was highly prevalent among the elderly Iranians regardless of their diabetes status. Also, periodontitis, tooth loss, and decayed teeth were significantly associated with increased odds of poor glycemic control among those with DM. Thus, it can be concluded that improving the oral health of the geriatric population may be a crucial part of improving the glycemic control among those with diabetes which has been frequently neglected. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-024-01434-2.
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Affiliation(s)
- Mohammad-Hossein Heydari
- Community Oral Health Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Evin City, Student Blvd. School of Dentistry, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shayan Sobhaninejad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Leili Alizadeh
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
| | - Soheila Darmiani
- Department of Endodontics, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
| | - Shima Bijari
- Department of Endodontics, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
| | - Parvin Parvaie
- Department of Oral and Maxillofacial Disease, School of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
| | - Soheila Bakhshandeh
- Community Oral Health Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shervan Shoaee
- Research Centre for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, No. 10, Al-E-Ahmad and Chamran Highway Intersection, Tehran, 1411713136 Iran
| | - Mohammad-Hossein Khoshnevisan
- Community Oral Health Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Evin City, Student Blvd. School of Dentistry, Tehran, Iran
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Borgnakke WS. Current scientific evidence for why periodontitis should be included in diabetes management. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2024; 4:1257087. [PMID: 38274772 PMCID: PMC10809181 DOI: 10.3389/fcdhc.2023.1257087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/13/2023] [Indexed: 01/27/2024]
Abstract
This Perspective provides a brief summary of the scientific evidence for the two-way links between periodontal diseases and hyperglycemia (diabetes mellitus [DM] and pre-DM). It delivers in a nutshell current scientific evidence for manifestations of hyperglycemia on periodontal health status and effects of periodontal diseases on blood glucose levels and in turn incidence, progression, and complications of diabetes. Of outmost importance is presentation of scientific evidence for the potential of routine periodontal treatment to lower blood glucose levels, providing a novel, economical tool in DM management. Non-surgical periodontal treatment ("deep cleaning") can be provided by dental hygienists or dentists in general dental offices, although severe cases should be referred to specialists. Such therapy can decrease the costs of DM care and other health care costs for people with DM. The great importance of a healthy oral cavity free of infection and subsequent inflammation - especially periodontitis that if untreated will cause loosening and eventually loss of affected teeth - has largely gone unnoticed by the medical community as the health care curricula are largely void of content regarding the bi-directional links between oral health and systemic health, despite elevation of blood glucose levels being an integral part of the general systemic inflammation response. The importance of keeping disease-free, natural teeth for proper biting and chewing, smiling, self-esteem, and pain avoidance cannot be overestimated. Medical and dental professionals are strongly encouraged to collaborate in patient-centered care for their mutual patients with - or at risk for - hyperglycemia.
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Affiliation(s)
- Wenche Sylling Borgnakke
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, United States
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