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Zheng M, Wang C, Ali A, Shih YA, Xie Q, Guo C. Prevalence of periodontitis in people clinically diagnosed with diabetes mellitus: a meta-analysis of epidemiologic studies. Acta Diabetol 2021; 58:1307-1327. [PMID: 34028620 DOI: 10.1007/s00592-021-01738-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/06/2021] [Indexed: 12/19/2022]
Abstract
AIMS The relationship between diabetes mellitus and periodontitis has long been discussed, but the conclusion of this relationship was controversial. We conducted this meta-analysis to explore the association between diabetes mellitus and the prevalence of periodontitis. METHODS PubMed, Embase, Web of Science, and the Cochrane Library were searched for studies reporting associations of periodontitis with diabetes. Gray literature was integrated from the Open-Gray database. Prevalence estimates and odds ratios were extracted by two independent reviewers and synthesized through meta-analyses. RESULTS Twenty-seven papers met the inclusion criteria involving 3092 diabetic patients and 23,494 controls. Overall prevalence of periodontitis was 67.8% in diabetics (combined types) and 35.5% in patients without diabetes (OR, 1.85; 95%CI, 1.61-2.11). Probing depth (MD 0.23; 95% CI, 0.17-0.29; I2 = 25%) and plaque index (MD, 0.20; 95% CI, 0.18-0.23; P = 0.59; I2 = 0%) severity scores were significantly greater among the diabetic group. CONCLUSIONS The prevalence and severity of periodontitis are greater in patients with diabetes than in non-diabetic populations.
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Affiliation(s)
- Mengwen Zheng
- Department of Stomatology, School of Medicine, The First Affiliated Hospital, Shihezi University, Shihezi, Xinjiang, China
| | - Cheng Wang
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ali Ali
- Sheffield Teaching Hospitals NIHR Biomedical Research Centre, Glossop Rd, Sheffield, S10 2JF, UK
| | - Yi An Shih
- School of Nursing, Peking University, Beijing, China
| | - Qinqin Xie
- Department of Stomatology, The Second Affiliated Hospital, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Chao Guo
- Department of Stomatology, School of Medicine, The First Affiliated Hospital, Shihezi University, Shihezi, Xinjiang, China.
- The Affiliated Hospital of Qingdao University, Qingdao,Shangdong, China.
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Wu CZ, Yuan YH, Liu HH, Li SS, Zhang BW, Chen W, An ZJ, Chen SY, Wu YZ, Han B, Li CJ, Li LJ. Epidemiologic relationship between periodontitis and type 2 diabetes mellitus. BMC Oral Health 2020; 20:204. [PMID: 32652980 PMCID: PMC7353775 DOI: 10.1186/s12903-020-01180-w] [Citation(s) in RCA: 142] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 06/29/2020] [Indexed: 02/05/2023] Open
Abstract
Background To systematically review the epidemiologic relationship between periodontitis and type 2 diabetes mellitus (T2DM). Methods Four electronic databases were searched up until December 2018. The manual search included the reference lists of the included studies and relevant journals. Observational studies evaluating the relationship between T2DM and periodontitis were included. Meta-analyses were conducted using STATA. Results A total of 53 observational studies were included. The Adjusted T2DM prevalence was significantly higher in periodontitis patients (OR = 4.04, p = 0.000), and vice versa (OR = 1.58, p = 0.000). T2DM patients had significantly worse periodontal status, as reflected in a 0.61 mm deeper periodontal pocket, a 0.89 mm higher attachment loss and approximately 2 more lost teeth (all p = 0.000), than those without T2DM. The results of the cohort studies found that T2DM could elevate the risk of developing periodontitis by 34% (p = 0.002). The glycemic control of T2DM patients might result in different periodontitis outcomes. Severe periodontitis increased the incidence of T2DM by 53% (p = 0.000), and this result was stable. In contrast, the impact of mild periodontitis on T2DM incidence (RR = 1.28, p = 0.007) was less robust. Conclusions There is an evident bidirectional relationship between T2DM and periodontitis. Further well-designed cohort studies are needed to confirm this finding. Our results suggest that both dentists and physicians need to be aware of the strong connection between periodontitis and T2DM. Controlling these two diseases might help prevent each other’s incidence.
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Affiliation(s)
- Chen-Zhou Wu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Yi-Hang Yuan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Hang-Hang Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Shen-Sui Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Bo-Wen Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Wen Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Zi-Jian An
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Si-Yu Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Yong-Zhi Wu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Bo Han
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Chun-Jie Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Long-Jiang Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China.
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Cirelli T, Nepomuceno R, Rios ACS, Orrico SRP, Cirelli JA, Theodoro LH, Barros SP, Scarel-Caminaga RM. Genetic polymorphisms in the Interleukins IL1B, IL4, and IL6 are associated with concomitant periodontitis and type 2 diabetes mellitus in Brazilian patients. J Periodontal Res 2020; 55:918-930. [PMID: 32648256 DOI: 10.1111/jre.12784] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/05/2020] [Accepted: 06/12/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To assess whether single nucleotide polymorphisms (SNPs) in the IL10, IL1A, IL1B, IL4, TNFA, IL6, OPG, RANK, and RANKL genes, "classically" related with periodontitis, could be associated with susceptibility to T2DM, and also with both diseases concomitantly. BACKGROUND There are common pathogenic mechanisms in type 2 diabetes mellitus (T2DM) and periodontitis, but the knowledge of the genetic aspect of this is limited. In patients affected by concomitant T2DM and periodontitis, whose incidence is increasing, there is scarce information regarding the gene-phenotype association, including whether there are genes able to influence both diseases as comorbidities. METHODS Periodontal clinical parameters and biochemical profile (Insulin, Fasting Glycemia, HbA1c, Triglycerides, Total Cholesterol, HDL-cholesterol, and LDL-cholesterol) data were obtained from 894 individuals divided into following three groups: Healthy (H; n = 347), Periodontitis (P; n = 348), and Periodontitis + T2DM (P + T2DM; n = 199). DNA from oral epithelial cells was collected for genotyping. Associations between SNPs and pathologies were tested by multiple logistic regression models, adjusting for age, sex, and smoking habits. We also investigated whether there are sex or smoking effects of each SNP in these phenotypes. RESULTS The rs1143634-GA (IL1B) SNP showed significantly less likely to develop P + T2DM for all population and mainly for women (adjusted OR = 0.37, 95% CI = 0.16-0.88), while women carrying the rs224320 CT (IL4) were more susceptible to develop P + T2DM (adjusted OR = 1.81, 95% CI = 1.04-3.15). Men carrying the rs1800795-CC (IL6) genotype were less likely to develop T2DM (adjusted OR = 0.12, 95% CI = 0.02-0.70, P = .01). CONCLUSIONS Some SNPs in the IL1B, IL4, and IL6 genes demonstrated sex-influenced association with concomitant periodontitis and T2DM, increasing the evidence of a common genetic component between these diseases and contributing with the understanding of their common pathogenic mechanisms.
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Affiliation(s)
- Thamiris Cirelli
- Department of Diagnosis and Surgery, São Paulo State University-UNESP, School of Dentistry at Araraquara, Araraquara, Brazil.,Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University-UNESP, School of Dentistry at Araraquara, Araraquara, Brazil
| | - Rafael Nepomuceno
- Department of Diagnosis and Surgery, São Paulo State University-UNESP, School of Dentistry at Araraquara, Araraquara, Brazil.,Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University-UNESP, School of Dentistry at Araraquara, Araraquara, Brazil
| | - Ana Cláudia S Rios
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University-UNESP, School of Dentistry at Araraquara, Araraquara, Brazil
| | - Silvana R P Orrico
- Department of Diagnosis and Surgery, São Paulo State University-UNESP, School of Dentistry at Araraquara, Araraquara, Brazil.,Advanced Research Center in Medicine, Union of the Colleges of the Great Lakes (UNILAGO), São José do Rio Preto, Brazil
| | - Joni A Cirelli
- Department of Diagnosis and Surgery, São Paulo State University-UNESP, School of Dentistry at Araraquara, Araraquara, Brazil
| | - Letícia H Theodoro
- Department of Surgery and Integrated Clinic, São Paulo State University-UNESP, School of Dentistry at Araçatuba, Araçatuba, Brazil
| | - Silvana P Barros
- Department of Periodontology, University of North Carolina at Chapel Hill-UNC, School of Dentistry, Chapel Hill, NC, USA
| | - Raquel M Scarel-Caminaga
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University-UNESP, School of Dentistry at Araraquara, Araraquara, Brazil
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4
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Barakat KI, Elborolosy SA. Does diabetes mellitus affect the parotid ductal system? A sialendoscopic evaluation. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 129:e243-e248. [PMID: 32111580 DOI: 10.1016/j.oooo.2019.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 09/02/2019] [Accepted: 09/08/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The aim of this study was to assess the existence of ductal changes in diabetics using sialendoscopy. STUDY DESIGN Twenty patients and 10 volunteers received bilateral parotid diagnostic sialendoscopy. Group I included 10 patients with uncontrolled diabetes (UCD); group II, 10 patients with controlled diabetes (CD); and group III, 10 nondiabetic controls (CG). Expected ductal changes were examined in 3 proposed distinct zones. A χ2 test was used to compare groups. RESULTS Ductal pathologic conditions were significantly higher in diabetic patients in all zones. Abnormalities were classified as stenosis, hyperemia, or others. In UCD, stenosis percentage was 55%, 90%, and 100% in zones 1, 2, and 3, respectively, compared with 30%, 40%, and 55% in CD and 5%, 5%, and 0% in CG (P < .01). Hyperemic changes in UCD were 90%, 90%, and 40% compared with 50%, 50%, and 20% in CD (P < .01) and 0% in CG. Comparing zones in UCD and CD indicated that stenosis increased significantly toward the proximal end, whereas hyperemia prevailed toward the distal end. CONCLUSIONS Significant ductal abnormalities were detected in the parotids of UCD and CD patients compared with CG. Ductal changes were higher in UCD compared with CD.
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Affiliation(s)
- Khaled Ibrahim Barakat
- Professor and Head of Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Minia University, Minia, Egypt; General Manager of Cranio-Maxillofacial Surgery Unit, Faculty of Dentistry, Minia University, Minia, Egypt; Director of Shifa Oral and Maxillofacial Surgery Center, Cairo, Egypt.
| | - Samir Ali Elborolosy
- Lecturer, Oral and Maxillofacial Surgery Department Faculty of Dentistry, Beni Suef University, Beni Suef, Egypt
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Coelho AS, Amaro IF, Caramelo F, Paula A, Marto CM, Ferreira MM, Botelho MF, Carrilho EV. Dental caries, diabetes mellitus, metabolic control and diabetes duration: A systematic review and meta-analysis. J ESTHET RESTOR DENT 2020; 32:291-309. [PMID: 31912978 DOI: 10.1111/jerd.12562] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/04/2019] [Accepted: 12/17/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To analyze articles aimed at evaluating the association between diabetes, metabolic control, diabetes duration, and dental caries. OVERVIEW A systematic search in PubMed, Cochrane Library, Embase, and Web of Science was conducted to retrieve papers in English, Portuguese, and Spanish, up to April 2019. The research strategy was constructed considering the "PECO" strategy. Only quantitative observational studies were analyzed. The risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale. The meta-analyses were performed based on random-effects models using the statistical platform R. A total of 69 articles was included in the systematic review and 40 in the meta-analysis. Type 1 diabetics have a significantly higher DMFT compared to controls. No significant differences were found between type 2 diabetics and controls and between well-controlled and poorly controlled diabetics. Concerning diabetes duration, all authors failed to find differences between groups. CONCLUSION Although there is still a need for longitudinal studies, the meta-analysis proved that type 1 diabetics have a high dental caries risk. CLINICAL SIGNIFICANCE It is necessary to be aware of all risk factors for dental caries that may be associated with these patients, making it possible to include them into an individualized prevention program.
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Affiliation(s)
- Ana Sofia Coelho
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - Inês Flores Amaro
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, Coimbra, Portugal
| | - Francisco Caramelo
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Laboratory of Biostatistics and Medical Informatics, University of Coimbra, Coimbra, Portugal
| | - Anabela Paula
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - Carlos Miguel Marto
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Experimental Pathology Institute, University of Coimbra, Coimbra, Portugal
| | - Manuel Marques Ferreira
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Institute of Endodontics, University of Coimbra, Coimbra, Portugal
| | - Maria Filomena Botelho
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - Eunice Virgínia Carrilho
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
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Schmolinsky J, Kocher T, Rathmann W, Völzke H, Pink C, Holtfreter B. Diabetes status affects long-term changes in coronal caries - The SHIP Study. Sci Rep 2019; 9:15685. [PMID: 31666549 PMCID: PMC6821733 DOI: 10.1038/s41598-019-51086-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 09/25/2019] [Indexed: 01/19/2023] Open
Abstract
We estimated effects of diabetes mellitus and metabolic control on long-term change in coronal caries and restorative status using 11-year-follow-up data from the population-based Study of Health in Pomerania. Data of 3731 participants with baseline and 5- and 11-year follow-up information were included. Diabetes was defined via self-reported physician´s diagnosis or intake of glucose-lowering drugs or hemoglobin A1c (HbA1c) ≥6.5% or fasting blood glucose levels ≥11.1 mmol/l. The diabetes status was defined as no diabetes (HbA1c < 6.5% or non-fasting blood glucose <11.1 mmol/l), subjects with known or undetected diabetes mellitus and HbA1c ≤ 7% (well-controlled diabetes), and subjects with known or undetected diabetes mellitus and HbA1c > 7% (poorly-controlled diabetes). The caries status was clinically assessed using the half-mouth method and the Decayed Missing Filled Surfaces (DMFS) index and its component scores were determined. Covariate-adjusted linear mixed models were evaluated. Rates in change in DMFS were significantly higher in subjects with poorly-controlled diabetes compared to subjects without diabetes. Subjects with poorly- and well-controlled diabetes had significantly higher rates in change in Missing Surfaces (MS) compared to subjects without diabetes. For the DFS, rates in change were significantly lower for subjects with well-controlled diabetes and higher for subjects with poorly-controlled diabetes as compared to subjects without diabetes. Concordantly, all rates in change increased proportional to HbA1c levels. Effects were even more pronounced in subjects with diabetes duration of ≥5 years. Subjects with poorly-controlled diabetes are at higher risk for caries progression compared to subjects without diabetes, especially in case of longer disease duration.
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Affiliation(s)
- Julia Schmolinsky
- Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Wolfgang Rathmann
- German Diabetes Center, Institute for Biometrics and Epidemiology, Düsseldorf, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.,German Centre of Diabetes Research, site Greifswald, Greifswald, Germany
| | - Christiane Pink
- Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Birte Holtfreter
- Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany.
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7
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Almusawi MA, Gosadi I, Abidia R, Almasawi M, Khan HA. Potential risk factors for dental caries in Type 2 diabetic patients. Int J Dent Hyg 2018; 16:467-475. [PMID: 29749033 DOI: 10.1111/idh.12346] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Diabetic patients are known to be at higher risk for dental caries. However, the role of potential risk factors such as blood glucose, salivary glucose and glycaemic control in the occurrence of dental caries in type 2 diabetes (T2D) is not clearly understood so far, and therefore, it was evaluated in this study. MATERIALS AND METHODS This cross-sectional study was conducted on 100 T2D patients from Saudi Arabia. The caries risk assessment was evaluated using the guidelines of Caries Management by Risk Assessment (CAMBRA). Cariogenic bacteria load in saliva was determined by a chair-side test kit. The levels of fasting blood glucose (FBG), salivary glucose and HbA1c were analysed. RESULTS Majority of the patients had dental caries (84%), exposed root surfaces (92%) and heavy plaque (73%), whereas 66% of patients suffered from xerostomia. The frequency of patients with high counts of Streptococcus mutans and Lactobacilli (LB) were 78% and 42%, respectively. There were significant associations between dental caries risk and FBG, HbA1c and salivary glucose. After categorizing the patients into 3 categories of glycaemic control, we observed a significant association between glycaemic control and dental caries risk. CONCLUSION Type 2 diabetes patients are at high risk for dental caries, which is directly associated with FBG, HbA1c and salivary glucose. This is the first study measuring dental caries and its risk factors in T2D patients from Saudi Arabia.
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Affiliation(s)
- M A Almusawi
- Department of Family and Community Medicine, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - I Gosadi
- Department of Family and Community Medicine, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - R Abidia
- College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - M Almasawi
- Dr. Abdulaziz Al Ajaji Dental Polyclinics, Riyadh, Saudi Arabia
| | - H A Khan
- Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
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Cicmil A, Govedarica O, Lečić J, Mališ S, Cicmil S, Čakić S. Oral Symptoms and Mucosal Lesions in Patients with Diabetes Mellitus Type 2. BALKAN JOURNAL OF DENTAL MEDICINE 2017. [DOI: 10.1515/bjdm-2017-0007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Summary
Background: Good glycoregulation at patients with diabetes mellitus is essential for prevention of many complications, including those in oral cavity. Results of numerous studies indicate that xerostomia and neurosensory oral disorders are present in type 2 diabetics. A review of the literature shows contradictory results about prevalence of oral mucosal lesions in diabetics. The aim of this study was to evaluate the presence of xerostomia, neurosensory disorders and mucosal lesions in oral cavity of type 2 diabetics.
Material and Methods: This study involved 90 adults, 60 with type 2 diabetes and 30 healthy subjects, aged 45-65 years. With regard to value of HbA1c level diabetics were divided into two groups: 30 subjects with satisfactory glycoregulation (HbA1c<9%) and 30 subjects with poor glycoregulation (HbA1c≥9%). All patients recruited into the study completed a questionnaire that included their demographic, medical and oral health data. Clinical examination of the oral mucosa was performed by a single examiner.
Results: In relation to the presence of xerostomia and dysgeusia between satisfactory controlled diabetics and healthy subjects a significant difference was observed (p<0.05). Compared with healthy subjects, poor controlled diabetics had significantly higher presence of xerostomia (p<0.001) and neurosensory disoders (p<0.05). A higher prevalence of oral mucosal lesions was found in poor controlled diabetics, but significant difference between groups was not observed (p>0.05). A significant positive correlation was revealed between smoking and glossodynia as well as smoking and glossopyrosis (p>0.05).
Conclusion: Glycemic control level seems to influence the susceptibility of type 2 diabetics to xerostomia and neurosensory disorders. Less clear is whether diabetes are corellated to oral mucosal lesions.
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Affiliation(s)
- Ana Cicmil
- Faculty of Medicine, University of East Sarajevo, Foca, Bosnia and Herzegovina
| | - Olivera Govedarica
- Faculty of Medicine, University of East Sarajevo, Foca, Bosnia and Herzegovina
| | - Jelena Lečić
- Faculty of Medicine, University of East Sarajevo, Foca, Bosnia and Herzegovina
| | | | - Smiljka Cicmil
- Faculty of Medicine, University of East Sarajevo, Foca, Bosnia and Herzegovina
| | - Saša Čakić
- Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia
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López-Pintor RM, Casañas E, González-Serrano J, Serrano J, Ramírez L, de Arriba L, Hernández G. Xerostomia, Hyposalivation, and Salivary Flow in Diabetes Patients. J Diabetes Res 2016; 2016:4372852. [PMID: 27478847 PMCID: PMC4958434 DOI: 10.1155/2016/4372852] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 05/31/2016] [Indexed: 11/29/2022] Open
Abstract
The presence of xerostomia and hyposalivation is frequent among diabetes mellitus (DM) patients. It is not clear if the presence of xerostomia and hyposalivation is greater in DM than non-DM patients. The aims of this systematic review are (1) to compare the prevalence rates of xerostomia, (2) to evaluate the salivary flow rate, and (3) to compare the prevalence rates of hyposalivation in DM versus non-DM population. This systematic review was conducted according to the PRISMA group guidelines by performing systematic literature searches in biomedical databases from 1970 until January 18th, 2016. All studies showed higher prevalence of xerostomia in DM patients in relation to non-DM population, 12.5%-53.5% versus 0-30%. Studies that analyzed the quantity of saliva in DM population in relation to non-DM patients reported higher flow rates in non-DM than in DM patients. The variation flow rate among different studies in each group (DM/CG) is very large. Only one existing study showed higher hyposalivation prevalence in DM than non-DM patients (45% versus 2.5%). In addition, quality assessment showed the low quality of the existing studies. We recommend new studies that use more precise and current definitions concerning the determination and diagnosis of DM patients and salivary flow collection.
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Affiliation(s)
- Rosa María López-Pintor
- Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid, Spain
- *Rosa María López-Pintor:
| | - Elisabeth Casañas
- Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid, Spain
| | - José González-Serrano
- Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid, Spain
| | - Julia Serrano
- Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid, Spain
| | - Lucía Ramírez
- Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid, Spain
| | - Lorenzo de Arriba
- Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid, Spain
| | - Gonzalo Hernández
- Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid, Spain
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Zhou X, Zhang W, Liu X, Zhang W, Li Y. Interrelationship between diabetes and periodontitis: Role of hyperlipidemia. Arch Oral Biol 2015; 60:667-74. [DOI: 10.1016/j.archoralbio.2014.11.008] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 11/13/2014] [Accepted: 11/17/2014] [Indexed: 12/11/2022]
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Soni S, Mehta M, M AD, P R, Pallavi, Kadanakuppe S, Nagashree, B V. Root caries among type 2 diabetes mellitus patients visiting a hospital. SPECIAL CARE IN DENTISTRY 2014; 34:273-7. [DOI: 10.1111/scd.12065] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sugandhi Soni
- JN Kapoor DAV Dental College and Hospital; Yamuna Nagar Haryana India
| | - Mohit Mehta
- MM College of Dental Sciences and Research; Mullana Haryana India
| | - Aruna Devi M
- VS Dental College and Hospital; Bangalore Karnataka India
| | - Radha P
- VS Dental College and Hospital; Bangalore Karnataka India
| | - Pallavi
- VS Dental College and Hospital; Bangalore Karnataka India
| | | | - Nagashree
- VS Dental College and Hospital; Bangalore Karnataka India
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Mohamed HG, Idris SB, Ahmed MF, Bøe OE, Mustafa K, Ibrahim SO, Astrøm AN. Association between oral health status and type 2 diabetes mellitus among Sudanese adults: a matched case-control study. PLoS One 2013; 8:e82158. [PMID: 24349205 PMCID: PMC3859584 DOI: 10.1371/journal.pone.0082158] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Accepted: 10/21/2013] [Indexed: 12/17/2022] Open
Abstract
AIM The purpose of this study was to compare the clinical and subjective oral health indicators of type 2 diabetic patients (T2DM) with age and gender matched non-diabetic controls. A second aim was to identify clinical and subjective oral health indicators that discriminate between well-controlled and poorly controlled T2DM patients as well as between patients with long and short duration of the disease. METHODS A total of 457 individuals participated in the study (154 T2DM cases and 303 non-diabetic controls). The T2DM group was sub-divided according to metabolic control [(well-controlled: glycosylated haemoglobin test 8%), (poorly controlled: glycosylated haemoglobin test > 8%)] and according to duration of T2DM [(long duration: >10 years), (short duration: 10 years)]. Participants were interviewed using a structured questionnaire including socio-demographics, lifestyle and oral health related quality of life factors. The clinical examination comprised full mouth probing depths, plaque index, tooth mobility index, furcation involvement and coronal and root surface caries. RESULTS The T2DM patients presented with more probing depths 4 mm, furcation involvement, tooth mobility, missing teeth, and oral impacts on daily performance (OIDP). The corresponding adjusted odds ratios and their 95% confidence intervals were 4.07 (1.74-9.49), 2.96 (1.36-6.45), 5.90 (2.26-15.39), 0.23 (0.08-0.63) and 3.46 (1.61-7.42), respectively. Moreover, the odds ratio was 2.60 (1.21-5.55) for the poorly controlled T2DM patients to have high levels of mobility index and 2.94 (1.24-6.94) for those with long duration of T2DM to have high decayed, missed and filled teeth (DMFT) values. CONCLUSION This study revealed that chronic periodontitis, tooth mobility, furcation involvement and OIDP were more prevalent among T2DM patients compared to their non-diabetic controls.
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Affiliation(s)
- Hasaan G Mohamed
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway ; Department of Oral Rehabilitation, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
| | - Shaza B Idris
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Mutaz F Ahmed
- Senior Consultant in Endodontics/Restorative Dentistry, Hamad Medical Corporation, Doha, Qatar
| | - Olav E Bøe
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Kamal Mustafa
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Salah O Ibrahim
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Anne N Astrøm
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
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Ladha K, Tiwari B. Type 2 diabetes and edentulism as chronic co-morbid factors affecting Indian elderly: an overview. J Indian Prosthodont Soc 2013; 13:406-12. [PMID: 24431769 PMCID: PMC3792296 DOI: 10.1007/s13191-013-0266-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 03/06/2013] [Indexed: 10/27/2022] Open
Abstract
In past 50 years, type 2 diabetes has emerged as one of the major public health problem. India leads the world with the largest number of diabetic patients and has a huge elderly population. The present article discusses the effect of diabetes and edentulism on the overall general health of elderly. The prevalence of type 2 diabetes and edentulism in Indian elderly and their inter-relationship has been discussed. Dentists must provide optimum oral care with special attention towards comprehensive periodontal management and oral hygiene awareness among diabetics to prevent tooth loss. Dental and medical professionals can improve patient management of the oral and overall effects of diabetes by implementing various awareness programs; organizing camps; distributing informative pamphlets and dietary counseling. Dentists can detect undiagnosed cases of diabetes and refer patients to physicians for further evaluation and management.
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Affiliation(s)
- Komal Ladha
- Department of Prosthodontics, ESIC Dental College & Hospital, New Delhi, India
| | - Bhawana Tiwari
- Department of Prosthodontics, ESIC Dental College & Hospital, New Delhi, India
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NEGRATO CA, TARZIA O, JOVANOVIČ L, CHINELLATO LEM. Periodontal disease and diabetes mellitus. J Appl Oral Sci 2013; 21:1-12. [PMID: 23559105 PMCID: PMC3881811 DOI: 10.1590/1678-7757201302106] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 09/05/2012] [Accepted: 12/11/2012] [Indexed: 12/28/2022] Open
Abstract
UNLABELLED Periodontal disease (PD) is one of the most commonly known human chronic disorders. The relationship between PD and several systemic diseases such as diabetes mellitus (DM) has been increasingly recognized over the past decades. OBJECTIVE The purpose of this review is to provide the reader with knowledge concerning the relationship between PD and DM. Many articles have been published in the English and Portuguese literature over the last 50 years examining the relationship between these two chronic diseases. Data interpretation is often confounded by varying definitions of DM, PD and different clinical criteria were applied to determine the prevalence, extent and severity of PD, levels of glycemic control and diabetes-related complications. METHODS This paper provides a broad overview of the predominant findings from research conducted using the BBO (Bibliografia Brasileira de Odontologia), MEDLINE, LILACS and PubMed for Controlled Trials databases, in English and Portuguese languages published from 1960 to October 2012. Primary research reports on investigations of relationships between DM/DM control, PD/periodontal treatment and PD/DM/diabetes-related complications identified relevant papers and meta-analyses published in this period. RESULTS This paper describes the relationship between PD and DM and answers the following questions: 1- The effect of DM on PD, 2- The effects of glycemic control on PD and 3- The effects of PD on glycemic control and on diabetes-related complications. CONCLUSIONS The scientific evidence reviewed supports diabetes having an adverse effect on periodontal health and PD having an adverse effect on glycemic control and on diabetes-related complications. Further research is needed to clarify these relationships and larger, prospective, controlled trials with ethnically diverse populations are warranted to establish that treating PD can positively influence glycemic control and possibly reduce the burden of diabetes-related complications.
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Affiliation(s)
- Carlos Antonio NEGRATO
- PhD in Medical Sciences, Research Support Center, Diabetics Association
of Bauru, São Paulo, Brazil
| | - Olinda TARZIA
- PhD in Oral Biochemistry, Bauru School of Dentistry, University of São
Paulo, Bauru, SP, Brazil
| | - Lois JOVANOVIČ
- MD, CEO & Chief Scientific Officer - Sansum Diabetes Research
Institute, Santa Barbara, USA
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Garton BJ, Ford PJ. Root caries and diabetes: risk assessing to improve oral and systemic health outcomes. Aust Dent J 2012; 57:114-22. [PMID: 22624749 DOI: 10.1111/j.1834-7819.2012.01690.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This report reviews the current understanding of the relationship between diabetes and root caries, and investigates the evidence for dental chairside testing of gingival crevicular blood (GCB) glucose levels to assess risk for type 2 diabetes mellitus. Diabetes is linked with the progression of periodontal disease and a greater number of exposed root surfaces at risk for root caries. The rapidly increasing prevalence of type 2 diabetes coupled with a general trend towards retention of teeth means that the number of patients with increased risk for root caries is expanding significantly. Many patients with diabetes or abnormal blood glucose levels are unaware of their condition or that they are at increased risk for oral disease. Systemic blood glucose concentrations are comparable to those found in GCB and therefore may be a useful adjunctive clinical aid in determining appropriate care for patients and providing timely referrals to general medical practitioners. Use of GCB testing within the dental clinic is described. It is proposed that future studies be undertaken to provide clinicians with improved risk assessment strategies and to evaluate GCB glucose screening models.
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Affiliation(s)
- B J Garton
- School of Dentistry, The University of Queensland, Brisbane
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Taylor GW, Borgnakke WS. Periodontal disease: associations with diabetes, glycemic control and complications. Oral Dis 2008; 14:191-203. [PMID: 18336370 DOI: 10.1111/j.1601-0825.2008.01442.x] [Citation(s) in RCA: 282] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE This report reviews the evidence for adverse effects of diabetes on periodontal health and periodontal disease on glycemic control and complications of diabetes. DESIGN MEDLINE search of the English language literature identified primary research reports published on (a) relationships between diabetes and periodontal diseases since 2000 and (b) effects of periodontal infection on glycemic control and diabetes complications since 1960. RESULTS Observational studies provided consistent evidence of greater prevalence, severity, extent, or progression of at least one manifestation of periodontal disease in 13/17 reports reviewed. Treatment and longitudinal observational studies provided evidence to support periodontal infection having an adverse effect on glycemic control, although not all investigations reported an improvement in glycemic control after periodontal treatment. Additionally, evidence from three observational studies supported periodontal disease increasing the risk for diabetes complications and no published reports refuted the findings. CONCLUSION The evidence reviewed supports diabetes having an adverse effect on periodontal health and periodontal infection having an adverse effect on glycemic control and incidence of diabetes complications. Further rigorous study is necessary to establish unequivocally that treating periodontal infections can contribute to glycemic control management and to the reduction of the burden of diabetes complications.
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Affiliation(s)
- G W Taylor
- School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA.
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Hintao J, Teanpaisan R, Chongsuvivatwong V, Dahlen G, Rattarasarn C. Root surface and coronal caries in adults with type 2 diabetes mellitus. Community Dent Oral Epidemiol 2007; 35:302-9. [PMID: 17615017 DOI: 10.1111/j.1600-0528.2007.00325.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine the effect of type 2 diabetes mellitus (DM) on coronal and root surface caries and to investigate some factors suspected of being related to or interacting with DM, that may be associated with coronal and root surface caries. METHODS A stratified cross-sectional study was conducted in 105 type 2 diabetic patients and 103 non-diabetic subjects of the same age and gender. Coronal and root surface caries, exposed root surfaces, periodontal status, stimulated salivary functions, oral hygiene status, oral health behaviors, and counts of mutans streptococci and lactobacilli were measured. RESULTS Type 2 diabetic patients compared with non-diabetic subjects had a higher prevalence of root surface caries (40.0% versus 18.5%; P = 0.001), a higher number of decayed/filled root surfaces (1.2 +/- 0.2 versus 0.5 +/- 0.1; P < 0.01) and a higher percentage of generalized periodontitis (98.1% versus 87.4%; P < 0.01); but the prevalence and decayed/filled surface of coronal caries was not significantly different (83.8% versus 72.8% and 8.0 +/- 9.4 versus 6.3 +/- 7.5 respectively). The factors associated with root surface caries included type 2 DM, a low saliva buffer capacity, more missing teeth, and existing coronal caries; whereas wearing removable dentures, more missing teeth, a high number of lactobacilli, and a low saliva buffer capacity were associated with coronal caries. CONCLUSION Type 2 DM is a significant risk factor for root surface, but not for coronal caries. Periodontal disease should be treated early in type 2 diabetic subjects to reduce the risk of subsequent root surface caries.
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Affiliation(s)
- J Hintao
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, Thailand
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Borges-Yáñez SA, Irigoyen-Camacho ME, Maupomé G. Risk factors and prevalence of periodontitis in community-dwelling elders in Mexico. J Clin Periodontol 2006; 33:184-94. [PMID: 16489944 DOI: 10.1111/j.1600-051x.2006.00897.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The objective of this study was to determine whether an association existed between chronic systemic diseases/conditions, risk factors common in old age, and the extent and severity of chronic periodontal disease. MATERIALS AND METHODS Sociodemographic and lifestyle characteristics were examined by contrasting rural, urban-marginal, and urban social environments in Central Mexico. Data were analysed with Analysis of Variance, chi2 tests, and multivariable logistic regression. RESULTS A total of 473 adults 60 years old and over were interviewed; 315 were also examined and underwent laboratory assays (participation rate, 66%); women, 62%; mean age 73+/-8 years; 23% edentulous. The distribution of periodontitis by sociodemographic variables showed differences across locales (73% low-urban, 57% middle-urban, 29% rural). The regression model indicated that periodontitis was more frequently associated with low-urban locale, higher systolic blood pressure, higher body mass index, and worse calculus readings, with an interaction whereby being obese and having a high calculus index was associated with a high probability of having periodontitis. CONCLUSIONS Overall periodontal conditions were fair. While we identified oral, systemic, and social variables that modulated the experience of periodontitis, it would appear that urban, low social class elders appeared to have worse periodontal conditions.
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Affiliation(s)
- S Aída Borges-Yáñez
- Facultad de Odontología, Universidad Nacional Autónoma de México, México DF, México.
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