Potential association between prediabetic conditions and gingival and/or periodontal inflammation

Abstract

Aims/Introduction Prediabetic conditions, which include impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), might be associated with chronic gingival and/or periodontal inflammation. However, the occurrence of this oral inflammation in prediabetic conditions is poorly understood. The present study aimed to assess the association between prediabetes and gingival and/or periodontal inflammation. Materials and Methods A total of 94 Puerto Rican men and women aged 40–65 years, who were residents of San Juan, Puerto Rico, and free of diabetes, were included in the study. All participants had at least one tooth site with clinical attachment loss ≥3 mm. Fasting and 2-h plasma glucose were collected. Gingival/periodontal inflammation was assessed by bleeding on gentle probing of the sulcus at six sites per tooth. Results Participants with the percentage of teeth with bleeding on probing (BOP) equal to or greater than the median were compared with those with the percentage of teeth with BOP less than median. Participants with high BOP tended to present higher IFG (odds ratio [OR] 5.5, 95% confidence interval [CI] 1.2–25.3) and/or prediabetic condition (OR 3.6, 95% CI 1.0–13.2) than those with a low percentage of BOP, adjusting for age, sex, smoking, alcohol consumption, waist circumference and number of missing teeth. Using the continuous form of the outcome, the corresponding adjusted least squares means of percentage of BOP were 26.8 (standard error of the mean [SEM] 2.3) and 43.8 (SEM 6.0) in normal and IFG, respectively (P = 0.01), and 27.0 (SEM 2.4) and 39.0 (SEM 5.3) among healthy and prediabetic individuals, respectively (P = 0.05). Conclusion IFG and/or prediabetes are strongly associated with BOP, a marker of chronic gingival/periodontal inflammation.

Prevalence of self‐reported gingival bleeding in a representative sample of the Brazilian adolescent population

“…Oral conditions, including periodontitis, remain a major public health challenge all over the world, with severe periodontitis affecting 7.4% of the global population (Kassebaum et al., ). There may be an association between prediabetes and gingival and/or periodontal bleeding on gentle probing of the periodontal tissues (Andriankaja & Joshipura, ). Also, self‐reported use of lipid‐lowering agents has shown a potential reduction effect on BOP levels, suggesting a connection between these systemic agents and oral inflammation (Andriankaja et al., ).…”

Periodontal findings in individuals with newly identified pre‐diabetes or diabetes mellitus

“…). A study of bleeding following probing in individuals who had not received a diagnosis of diabetes revealed that patients above the median bleeding percentage demonstrated an increased likelihood of impaired fasting glucose (odds ratio = 5.5, 95% CI 1.2–25.3) or impaired glucose tolerance (odds ratio 3.6, 95% CI 1.0–13.2; Andriankaja & Joshipura ). In another study, periodontal parameters were assessed in three groups of individuals: (i) pre‐diabetes (defined by FPG or HbA1c), (ii) previously identified pre‐diabetes which was controlled with dietary modification and (iii) normal controls.…”

Cross‐sectional associations of impaired glucose metabolism measures with bleeding on probing and periodontitis

“…Two of these studies have been cross-sectional (Andriankaja & Joshipura, 2014; Noack et al, 2000), one used a case-control study design (Javed et al, 2012), and one performed a cross-sectional analysis within a longitudinal study (Cherry-Peppers & Ship, 1993), all of which have been limited by small sample sizes.…”