Diabetes patients ‘need better education about oral health’
By Joanna Lyford, Senior medwireNews Reporter
04 April 2013
Eur J Med Res 2013; Advance online publication

medwireNews: There is a strong association between Type 2 diabetes mellitus and chronic periodontitis, say researchers, who call for greater awareness of this link among healthcare practitioners and patients.

"[D]entists and diabetologists should inform diabetic patients about their increased risk for periodontitis and the importance of excellent compliance in diabetic and periodontal treatment," advise Knut Weinspach (Hannover Medical School, Germany) and co-authors.

Weinspach's team surveyed 448 people who were participating in a nationwide diabetes information program (the so-called "diabetestour"). The patients' mean age was 59.65 years, 244 were women, 101 had Type 1 diabetes, and 236 had Type 2 diabetes. All underwent a dental examination and were asked about their knowledge of the relationship between diabetes and periodontitis.

Writing in the European Journal of Medical Research, Weinspach et al report that the number of decayed, missing, or filled teeth - a marker of dental health - was lowest for people with Type 1 diabetes, intermediate for those without diabetes, and highest for people with Type 2 diabetes, at 16.12, 17.81, and 18.80, respectively.

The same pattern was seen for another marker of dental health, the periodontal screening index, with scores being lowest in those with Type 1 diabetes, intermediate in those without diabetes, and highest in people with Type 2 diabetes, at 2.79, 3.26, and 3.52, respectively.

The overall prevalence of periodontitis was approximately 65% in people with Type 1 diabetes, 85% in nondiabetics, and 90% in Type 2 diabetics, the authors note.

Interestingly, the prevalence of periodontitis was not correlated with diabetes control, as indicated by glycated hemoglobin levels. However, multivariate analysis identified older age, male gender, and higher body mass index as significant independent predictors for periodontal disease among the participants with either form of diabetes.

Finally, when asked "do you know that periodontitis and diabetes negatively affect each other?," people with Type 1 diabetes were significantly more likely to answer "yes" than were nondiabetics and those with Type 2 diabetes. Nevertheless, 55% of all participants were unaware of the link between the two conditions.

Weinspach et al suggest that the better dental health observed in people with Type 1 diabetes is most likely a function of their younger age; "this hypothesis is supported by the fact that the older diabetics (≥65 years) were 2.4 times more likely to be affected by periodontitis when compared to younger diabetics (<65 years)," they write.

The researchers conclude: "The results of the present investigation indicate a strong correlation between Type 2 diabetes and (1) periodontitis and (2) a deficient knowledge about the mutual influence between diabetes and periodontitis. This lack of knowledge emphasizes the need for more information about oral health care in patients with diabetes mellitus."

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