The Prevalence and Associated Factors of Periodontitis According to Fasting Plasma Glucose in the Korean Adults

Abstract

Although the relationship between diabetes and periodontitis is well established, the association between periodontitis and prediabetes has been investigated less extensively. Furthermore, there has been little research on the prevalence of periodontitis among individuals with prediabetes and diabetes as well as in the overall population using nationally representative data.Among 12,406 adults (≥19 years’ old) who participated in the 2012–2013 Korea National Health and Nutrition Examination Survey, a total of 9977 subjects completed oral and laboratory examinations and were included in this analysis. Periodontitis was defined as a community periodontal index score of ≥3 according to the World Health Organization criteria. The fasting plasma glucose level was categorized into the following 5 groups: normal fasting glucose (NFG) 1 (<90 mg/dL), NFG 2 (90–99 mg/dL), impaired fasting glucose (IFG) 1 (100–110 mg/dL), IFG 2 (111–125 mg/dL), and diabetes (≥126 mg/dL).Overall, the weighted prevalence of periodontitis among the Korean adult population was 24.8% (23.3–26.4%) (weight n = 8,455,952/34,086,014). The unadjusted weighted prevalences of periodontitis were 16.7%, 22.8%, 29.6%, 40.7%, and 46.7% in the NFG 1, NFG 2, IFG 1, IFG 2, and diabetes groups, respectively (P < 0.001). After adjusting for age, sex, smoking history, heavy alcohol drinking, college graduation, household income, waist circumference, serum triglyceride level, serum high-density lipoprotein cholesterol level, and the presence of hypertension, the adjusted weighted prevalence of periodontitis increased to 29.7% in the IFG 2 group (P = 0.045) and 32.5% in the diabetes group (P < 0.001), compared with the NFG 1 group (24%). The odds ratios for periodontitis with the above-mentioned variables as covariates were 1.42 (95% confidence interval [CI] 1.14–1.77, P = 0.002) in the diabetes group and 1.33 (95% CI 1.01–1.75, P = 0.044) in the IFG 2 group, respectively, compared with the NFG1 group.In conclusion, a higher range of IFG levels as well as diabetes, were positively associated with chronic periodontitis in a representative sample of Korean adults. This study suggests that individuals with a higher range of IFG levels before diabetes are at risk of periodontitis, and may benefit from dental screening.

Status of Tobacco Smoking and Diabetes with Periodontal Disease

“…Total of 87% of smokers and 97% of diabetics had periodontitis similar to previous studies. 1,21,25 The association of periodontitis was found to be statistically significant with tobacco smoking, diabetes, hypertension and age but not with sex and family history of diabetes (Table 1, 3). Higher age predicted greater incidence of periodontal disease, however no difference in the proportion of periodontal disease was seen in male and female similar to previous studies.…”

Comparison of HIF1A-AS1 and HIF1A-AS2 in regulating HIF-1α and the osteogenic differentiation of PDLCs under hypoxia

“…Periodontitis and malocclusion along with caries are significant public oral diseases with extremely high incidence rates. Epidemiologic studies show that more than 50% of adults suffer from periodontitis and severe periodontitis is estimated to occur in approximately 5-20% of adults worldwide (1)(2)(3). The prevalence of malocclusion among children is also more than 50%.…”

Impaired glucose metabolism is associated with tooth loss in middle-aged adults: The Northern Finland Birth Cohort Study 1966

“…Tooth loss can substantially impair one's quality of life, causing limited chewing ability, poor dietary intake and functional disorders [1]. Research has shown diabetes and cardiovascular diseases to associate with oral health and tooth loss [2][3][4][5], and elevated glucose levels with common periodontal disease [6][7][8]. Similar finding has been reported between glucose concentration and the number of teeth [8].…”

“…Studies have suggested a bidirectional connection between, for example, diabetes and periodontal disease (a chronic inflammatory condition of supporting tissues of the teeth); periodontal disease is a complication of diabetes that plays an important role in poorly controlled diabetes [19]. Moreover, recent studies have reported an association between impaired glucose metabolism and periodontal disease [6,8].…”