Association of the Severity of Periodontal Disease With Organ Complications in Type 1 Diabetic Patients

Abstract

This study examined the relationship between the severity of periodontal disease and organ complications in long-term Type 1 or insulin-dependent diabetes mellitus patients, taking account of the severity and concomitant existence of these complications. The population studied consisted of 26 Type 1 diabetics 26 to 34 years old, who had had diabetes for at least 10 years. Severity of periodontal disease was shown to increase with severity of organ complications. Patients with advanced complications had significantly more bleeding on probing, pockets > or = 4 mm deep, and more attachment loss than patients with incipient complications or no complications. Stepwise multiple regression analysis showed that the existence of advanced complications was the only diabetes-related factor predicting pockets > or = 4 mm deep. Subgingival calculus, sex, and smoking were other significant variables. Retinopathy was the organ complication most suited to comparison, since it is usually the first to appear and can easily be classified from non-existent to severe. Differences in severity of periodontal disease were less obvious if metabolic balance alone was considered than between subgroups formed on the basis of the existence of advanced complications. Severity of periodontal disease and the existence of complications were more closely related to long-term glucose balance than single, most recent HbA1 values. Prevalence of pockets at sites with subgingival calculus increased with severity of complications.(ABSTRACT TRUNCATED AT 250 WORDS)

The Role of Genetic Predisposition in Diagnosis and Therapy of Periodontal Diseases in Type 1 Diabetes Mellitus

“…[38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57] Individuals with DM tend to have a higher prevalence of periodontal diseases and more severe and rapidly progressing forms than those who do not have DM. 41,48 DM is a known risk factor for periodontitis in adults.…”

Communication and Community

“…There is more attachment loss among adult IDDM subjects with poor metabolic balance and/or multiple complications, and in these patients probed pocket depth ≥ 4 mm re-occurs faster after periodontal therapy (Tervonen & Karjalainen 1997). Further, periodontal disease associates with retinopathy (Rosenthal et al 1988, Karjalainen et al 1994, renal disease and cardiovascular complications (Thorstensson et al 1996) as well as neuropathy (Rosenthal 1988, Moore et al 1999.…”

“…However, there is a difference in the regular use of toothpicks, as 46% of long-and 31% of short-duration diabetic patients use toothpicks regularly, while 30% of non-diabetic subjects do that (Thorstensson et al 1989a). Among IDDM patients, infrequent interdental cleaning is related to poor metabolic control or advanced complications (Karjalainen et al 1994).…”

“…According to a longitudinal study concerning both type 1 and type 2 diabetic patients, diabetic patients fail more dental appointments than non-diabetic subjects (Pohjamo et al 1995). Diabetic patients require more emergency dental care than non-diabetic patients (Thorstensson et al 1989a), and IDDM patients with poor metabolic control or advanced complications visit dentist less regularly than those with good diabetes status (Karjalainen et al 1994). Although the level of oral hygiene practices and the frequency of dental visiting among diabetic patients seems to be moderately good, it is alarming that poor adherence is shown by the patients with poor metabolic balance and complications.…”

“…Psychological features, such as self-efficacy, have been found to associate with adherence to self-care regimens (Littlefield et al 1992, Stewart et al 1997. Poor control and/or complications of diabetes are related to the prevalence and severity of inflammatory periodontal disease (Karjalainen et al 1994, Oliver & Tervonen 1994, Yalda et al 1994 and to dental caries among children and adolescents . There is evidence that periodontal disease is related to metabolic control (Miller et al 1992, Grossi & Genco 1998) and complications (Thorstensson et al 1996) in insulin-dependent diabetes mellitus (IDDM).…”