Periodontal disease progression and glycaemic control among Gullah African Americans with type‐2 diabetes

Abstract

Aim-To evaluate associations between glycaemic control and periodontitis progression among Gullah African Americans with type-2 diabetes mellitus (T2DM). Materials and Methods-From an ongoing clinical trial among T2DMGullah, we extracted a cohort previously in a cross-sectional study (N 5 88). Time from baseline (previous study) to followup (trial enrollment, before treatment interventions) ranged 1.93-4.08 years [mean 5 2.99, standard deviation (SD) = 0.36]. We evaluated tooth site-level periodontitis progression [clinical attachment loss (CAL) worsening of ≥ 2 mm, periodontal probing depth (PPD) increases of ≥ 2 mm and bleeding on probing (BOP) from none to present] by glycaemic control status (well-controlled = HbA 1c < 7%, poorly-controlled = HbA 1c ≥ 7%) using multivariable generalized estimating equations logistic regression, nesting tooth sites/person.Results-Poorly-controlled T2DM (68.18%) was more prevalent than well-controlled T2DM (31.82%). Proportions of tooth sites/person with CAL progression between baseline and follow-up ranged 0.00-0.59 (mean = 0.12, SD = 0.12), while PPD and BOP progression ranged 0.00-0.44 (mean = 0.09, SD = 0.11) and 0.00-0.96 (mean = 0.24, SD = 0.18), respectively. Site-level PPD at baseline was a significant effect modifier of associations between poorly-controlled T2DM and sitelevel CAL and PPD progression [adjusted odds ratios (OR) according to poorly-controlled T2DM among PPD at baseline = 3, 5 and 7 mm, respectively: CAL progression = 1.93, 2.64, and 3.62, PPD progression = 1.98, 2.76, and 3.84; p < 0.05 for all]. Odds of site-level BOP progression were increased (OR = 1.24) for poorly-controlled T2DM, yet the results were not significant (p = 0.32).Conclusions-These findings from a distinct, homogenous population further support the clinical relevance of identifying patients with poor glycaemic control and periodontitis, particularly among those with disparities for both diseases. There is evidence that periodontal disease can worsen diabetic control capabilities and (vice versa) that proper management of periodontal disease can improve diabetic control (Soskolne & Klinger 2001). The host inflamma-tory response appears to be the critical determinant for the susceptibility to and the severity of marginal periodontitis, especially in systemically compromised individuals (Williams & Offenbacher 2000, Takeda et al. 2006, including those with type-2 diabetes mellitus (T2DM). Results from three independent studies that examined the role of periodontal disease as a factor complicating the severity of diabetes consistently indicate that those subjects with severe periodontitis exhibit more diabetes complications compared with those with no or mild periodontitis, suggesting that severe periodontitis confers a significant risk for these complications (Grossi 2001). Also, in a longitudinal study of native Americans from the Gila River Reservation, the Pima Indians who exhibited severe periodontitis at baseline subsequently had a worse glycated α-haemoglobin (HbA 1c ) leve...

Successes, challenges and lessons learned: Community-engaged research with South Carolina's Gullah population

“…The first project was a genetic/epidemiologic cross-sectional study that investigated the prevalence of caries and periodontal disease in the T2DM Gullah population (Fernandes et al 2009; Marlow et al 2011a). The second project was a double-blind clinical trial to investigate the need for antibiotic therapy in conjunction with mechanical non-surgical therapy in the treatment of periodontal disease in this same population (Bandyopadhyay et al 2010; Marlow et al 2011b). Membership in the SIFP enhanced rapport, communication, cultural sensitivity and cultural humility.…”

Diabetes and Periodontitis—A Dental Hygienist’s Perspective

“…& Poorly controlled diabetes increases the risk for deterioration of the periodontium, including clinical attachment loss, progression of periodontal pocket depth, and alveolar bone loss [27][28][29]. There may be a Bdose-response^rela-tionship: as glycemic control worsens, the greater the adverse effect diabetes has on periodontal health [30].…”

Periodontal and systemic health conditions of the patients treated in the student clinic of department of periodontology betweeen the years 2012-2014

“…TARTIŞMA MDP primer etiyolojik faktör olmasına rağmen periodontal hastalıkların başlaması, ilerlemesi ve şiddetlenmesinde rol oynayan farklı risk faktörlerinin olduğunu gösteren geniş epidemiyolojik ve deneysel çalışmalar vardır. [12][13][14][15] Bu çalışmalara göre; çevresel (cinsiyet, sigara, alkol), sistemik (diabetes mellitus, obezite, kardiyovasküler hastalıklar vb) ve genetik faktörler periodontal hastalıklar ile ilişkilidir. 16,17 Çalışmamızın sonuçlarıyla benzer olarak kadınların daha sık diş fırçaladığını destekleyen 1999 yılında Japonya'da gerçekleştirilen çalışmada erkeklerin % 60.9'nun, kadınların % 88.8'nin yatmadan önce diş fırçaladıkları rapor edilmiştir.…”