Periodontal disease in adults with diabetes, prevalence and risk factors. Results of an observational study

Abstract

Summary Aim We sought (a) to assess the association between periodontal disease and diabetes, controlling for socio‐demographic characteristics, comorbidities, oral health status and lifestyle variables; (b) to identify which of these variables are independently associated with periodontal disease among diabetes sufferers. Methods We conducted a case‐control study using data from the National/European Health Interview Surveys, conducted from 2003 to 2014 in Spain. We included 65 295 subjects ≥40 years. Diabetes status was self‐reported. One non‐diabetic control was matched by the year‐of‐survey, age and sex for each diabetic patient. The presence of periodontal disease was defined using the answer "my teeth bleed spontaneously or while brushing" or/and "my teeth move" to the following question: "Do you suffer of any of these dental and oral disorders or disease?". Independent variables included demographic, socio‐economic and healthcare related variables, oral health status and comorbidities. Results The prevalence of periodontal disease was higher among those suffering from diabetes than their non‐diabetes controls (23.8% vs 19.5%; P < 0.001). Adjusted OR of periodontal disease for subjects with diabetes was 1.22 (95% CI; 1.03‐1.45). Among diabetes sufferers, missing teeth status (OR 2.08, 95% CI; 1.70‐2.53), suffering osteoporosis (OR 1.41, 95% CI; 1.07‐1.63) and suffering depression (OR 1.39, 95% CI; 1.12‐1.71) were positively associated with higher risk of periodontal disease. Older ages, using private insurance and university education level were associated with lower rates of periodontitis. Conclusions Diabetes subjects have an increased likelihood of periodontal disease. Dentists and physicians should increase their awareness with their diabetic patients, especially those with lower educational level, with missing teeth, osteoporosis and depression.

Relationship Between Oral Health and Clinical Osteoporosis Among Hospitalized Patients with and Without Diabetes

“…Another study by Richa et al found increased clinical attachment loss, bleeding, and gingivitis (all measures of PD) among postmenopausal women with OP compared to those without OP [15]. In a study examining PD in DM patients, deMiguel-Infante et al found significant associations between missing teeth, OP, and a higher risk for PD [16]. Unlike these studies, our study did not find an association between PD and having a diagnosis of OP independent of the presence of DM.…”

“…Inflammation, in addition to being associated with poorer glycemic control and increased risk for cardiovascular disease, is also associated with OP and increased fracture risk [9][10][11][12]. Furthermore, there is a known association between OP and PD [13][14][15][16]. PD, OP, and DM all share common risk factors like older age, inflammation, tobacco use, and stress but could also directly interact with one another.…”

Prevalence of diabetes among patients and the assessment of the awareness of the bidirectional relation between diabetes and periodontal disease

“…[ 39 ] Dentists and physicians should increase their awareness with their diabetic patients, especially those with lower educational levels, with missing teeth, osteoporosis, and depression. [ 40 ]…”

Periodontal disease and systemic health

“…Diabetes mellitus has a number of well-known complications such as retinopathy, nephropathy, poor wound healing, neuropathy, macro and microvascular impairment and periodontal disease (29,30). an observational study conducted by De Miguel-Infants and coworkers in adults aged 40 or older, observed that diabetic patients have an increased risk of developing periodontal disease (31).…”