Oral health in rural South African type 2 diabetic patients

Abstract

Objectives: According to The World Oral Health Report 2003, oral diseases remain a major public health problem worldwide. However, oral health is seen as a very low priority in the African Region, where extreme poverty means that the limited resources available to the health sector are directed towards life-threatening conditions such as HIV/AIDS, tuberculosis and malaria. The mission of the Oral Health Programme at the Regional Office of WHO for Africa is to assist Member States to achieve those goals by means of a Regional Strategy. In fact in September 1998, the WHO Regional Committee for Africa adopted a ten year (1999-2008) Oral Health Plan for the African Region (AFR/RC48/9) with the aim of fundamentally improving community oral health. Its cornerstone is provision of the technical and managerial resources to efficiently and effectively deliver affordable intervention that matches the oral health needs of the community. Data Sources: This review presents major achievements made since the WHO Regional Strategy was launched in 1998 and priority actions which should be taken to further implement the Regional Strategy. Conclusions: WHO/AFRO recommends more commitment at country level to improve oral health and to reinforce partnerships in order to mobilize and coordinate the human, financial, material and institutional resources needed to implement, monitor and evaluate the Regional Strategy.

Periodontal disease and diabetes mellitus

“…One prospective study conducted with T1D did not show any association between the degree of glycemic control and PD but a positive association with local oral hygiene measures 82 , and another study, that was cross-sectional, has regarded this association 102 . Five of the seven reports published regarding the association between glycemic control and PD in T2D 10,43,59,75,106 have found this association and two did not 12,80 . We have found five studies providing information on the differences in periodontal health in groups of mixed types of diabetes 5,37,45,61,68 ; three have found this association 37,61,68 and two did not 5,45 .…”

Periodontal disease: associations with diabetes, glycemic control and complications

“…Primary research reports in the literature published since 2000 investigating relationships between glycemic control level and periodontal disease have included studies with subjects with type 1 diabetes exclusively (one study), type 2 diabetes exclusively (seven studies), or a combination of individuals with either type 1 or type 2 diabetes (three studies) (Table 2). Only seven of the 12 reports published regard the association between degree of glycemic control and periodontal disease specifically in type 2 diabetes (Sandberg et al , 2000; Tsai et al , 2002; Lu and Yang, 2004; Campus et al , 2005; Chuang et al , 2005; Jansson et al , 2006; Peck et al , 2006) . Five of the latter found poorer glycemic control to be a significant factor associated with poorer periodontal health, the association was borderline significant in one study of dialysis patients (Chuang et al , 2005) and no difference was found in the remaining study (Sandberg et al , 2000).…”

“…Five of the latter found poorer glycemic control to be a significant factor associated with poorer periodontal health, the association was borderline significant in one study of dialysis patients (Chuang et al , 2005) and no difference was found in the remaining study (Sandberg et al , 2000). Among the studies providing information on differences in periodontal health classified by glycemic control status, most have been cross‐sectional, with eight of 12 publications reporting more prevalent or more severe periodontal disease in those with poorer glycemic control (Tervonen et al , 2000; Tsai et al , 2002; Guzman et al , 2003; Lu and Yang, 2004; Negishi et al , 2004; Campus et al , 2005; Jansson et al , 2006; Peck et al , 2006) and four reporting no differences (Sandberg et al , 2000; Arrieta‐Blanco et al , 2003; Karikoski and Murtomaa, 2003; Chuang et al , 2005). There was one follow‐up study identified (evidence level II‐2) that was published since 2000 (Karikoski and Murtomaa, 2003).…”

Pre‐diabetes and well‐controlled diabetes are not associated with periodontal disease: the SHIP Trend Study

“…), small sample size (Peck et al. , Javed et al. ), and lack of a constant, globally accepted HbA1c cut‐off value to define poorly controlled diabetes.…”