Influence of Diabetes Mellitus on Dental Condition and Periodontal Status

Czech version

Authors: H. Poskerová ¹; P. Bořilová Linhartová ^1,2; M. Cvanová ³; L. Izakovičová Hollá ^1,2
Authors‘ workplace: Stomatologická klinika LF MU a FN u sv. Anny, Brno ¹; Ústav patologické fyziologie LF MU, Brno ²; Institut biostatistiky a analýz LF MU, Brno ³
Published in: Česká stomatologie / Praktické zubní lékařství, ročník 118, 2018, 1, s. 3-12
Category:

Overview

Introduction, aim: Diabetes mellitus (DM) and periodontitis are chronic inflammatory diseases with high prevalence. Both conditions possess some common traits and can mutually affect each other. The aim of the study was to investigate the state of teeth and periodontium in Czech diabetic patients and contribute to the identification of genetic risk factors of both diseases.

Methods:
We examined and mutually compared three groups of subjects: type 1 diabetic patients (T1DM), type 2 diabetic patients (T2DM) and subjects without diabetes mellitus (controls). The subjects included in the study underwent clinical, radiological and further we focused on the analysis of microbiological composition of subgingival plaque. Evaluation of results was performed by statistical software IBM SPSS Statistics 23.

Results:
The study comprised a total of 141 subjects (32 with T1DM, 51 with T2DM, 58 controls), aged 35–65 years, examined during 2010–2015. We found that the state of teeth and periodontium in diabetic (mainly T2DM) patients was worse than in subjects without diabetes. This finding was confirmed for plaque index and gingival index, number of extracted teeth, the presence of teeth replacement and other parameters evaluating the presence and severity of periodontitis. The differences in the representation of periodontal pathogens and their quantity among the groups were minimal. Patients with T2DM and diabetic nephropathy had worse state of the periodontium; this finding was not proven in patients with insufficiently controlled diabetes or the disease duration.

Conclusion:
In diabetic patients, a more frequent occurrence of inflammatory periodontal diseases and other diseases of the oral cavity is expected. Based on clinical examination and anamnestic data, the dentist can presume DM, early treatment of periodontal disease contributes to improved general health of the patient.

Keywords:
diabetes mellitus – chronic periodontitis – periodontal index – radiological examination – periodontal pathogens

Sources

1. Álamo, S. M., Soriano, Y. J., Sarrión Pérez, M. G.: Dental considerations for the patient with diabetes. J. Clin. Exp. Dent., roč. 3, 2011, č. 1, s. 25–30.

2. Apoorva, S. M., Sridhar, N., Suchetha, A.: Prevalence and severity of periodontal disease in type 2 diabetes mellitus (non-insulin-dependent diabetes mellitus) patients in Bangalore city: an epidemiological study. J. Indian Soc. Periodontol., roč. 17, 2013, č. 1, s. 25–29.

3. Borgnakke, W. S., Ylöstalo, P. V., Taylor, G. W., Genco, R. J.: Effect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence. J Clin Periodontol, roč. 40, 2013, suppl. 14, s. 135–152.

4. Borilova Linhartova, P., Kastovsky, J., Lucanova, S., Bartova, J., Poskerova, H., Vokurka, J., Fassmann, A., Kankova, K., Izakovicova Holla, L.: Interleukin-17A gene variability in patients with type 1 diabetes mellitus and chronic periodontitis: its correlation with IL-17 levels and the occurrence of periodontopathic bacteria. Mediators Inflamm., 2016, 2979846.

5. Bořilová Linhartová, P., Valová, S., Kaštovský, J., Poskerová, H., Vokurka, J., Fassmann, A., Izakovičová Hollá, L.: Genová variabilita v imunoregulačních faktorech u pacientů s chronickou parodontitidou a diabetes mellitus. Čes. Stomat., Prakt. zub. Lék., roč. 115–63, 2015, č. 4, s. 89–97.

6. Campus, G., Salem, A., Uzzau, S.: Diabetes and periodontal disease: a case-control study. J. Periodontol., roč. 76, 2005, č. 3, s. 418–425.

7. Chaffee, B. W., Weston, S. J.: Association between chronic periodontal disease and obesity: a systematic review and meta-analysis. J. Periodontol., roč. 81, 2010, č. 12, s. 1708–1724.

8. Chapple, I. L. C., Genco, R.: Diabetes and periodontal diseases: consensus report of the Joint EFP/AAP Workshop on periodontitis and systemic diseases. J. Clin. Periodontol., roč. 40, 2013, Suppl. 14, s. 106–112.

9. Chávarry, N. G. M., Vettore, M. V., Sansone, C., Sheiham, A.: The relationship between diabetes mellitus and destructive periodontal disease: a meta-analysis. Oral Health Prev. Dent., roč. 7, 2009, č. 2, s. 107–127.

10. Dušková, J.: Stomatologická onemocnění u diabetu. 1. vyd., Professional Publishing, Praha, Czechia, 2000, 56 s. ISBN: 80-86419-05-3.

11. Dušková, J.: Riziko diabetu pro onemocnění dutiny ústní. Med. Rev., roč. 7, 2001, č. 1, s. 12–14.

12. Dušková, J., Broukal, Z.: Vztah diabetes mellitus a onemocnění parodontu se zřetelem k mikrobiologickým nálezům v dutině ústní. (Literární přehled). Čs. Stomat., roč. 92, 1992, č. 6, s. 347–349.

13. Dušková, J., Broukal, Z.: Vztah onemocnění parodontu a diabetu – metaanalýza výsledků průřezových a intervenčních studií. Prakt. Lék., roč. 84, 2004, č. 10, s. 556–563.

14. Dye, B. A., Genco, R. J.: Tooth loss, pocket depth, and HbA1c information collected in a dental care setting may improve the identification of undiagnosed diabetes. J. Evid.-Based Dent. Pract., roč. 12, 2012, suppl. 3, s. 12–14.

15. Ebersole, J. L., Hol, S. C., Hansard, R., Novak, M. J.: Microbiologic and immunologic characteristics of periodontal disease in Hispanic americans with type 2 diabetes. J. Periodontol., roč. 79, 2008, č. 4, s. 637–646.

16. Engebretson, S., Kocher, T.: Evidence that periodontal treat-ment improves diabetes outcomes: a systematic review and meta-analysis. J. Clin. Periodontol., roč. 40, 2013, suppl. 14, s. 153–163.

17. Fagard, R. H., Nilsson, P. M.: Smoking and diabetes – the double health hazard! Prim. Care Diabetes, roč. 3, 2009, č. 4, s. 205–209.

18. Friedecký, B., Kratochvíla, J.: Diabetes mellitus – laboratorní diagnostika a sledování stavu pacientů. http://www.cskb.cz/res/file/doporuceni/DM/DM_dop_201601.pdf. Přístup: 26. červenec 2016

19. Garcia, D., Tarima, S., Okunseri, C.: Periodontitis and glycemic control in diabetes: NHANES 2009 to 2012. J. Periodontol., roč. 86, 2015, č. 4, s. 499–506.

20. Hintao, J., Teanpaisan, R., Chongsuvivatwong, V.: The microbiological profiles of saliva, supragingival and subgingival plaque and dental caries in adults with and without type 2 diabetes mellitus. Oral Microbiol. Immunol., roč. 22, 2007, č. 3, s. 175–181.

21. Holtfreter, B., Albandar, J. M., Dietrich, T.: Standards for reporting chronic periodontitis prevalence and severity in epidemiologic studies: proposed standards from the Joint EU/USA Periodontal Epidemiology Working Group. J. Clin. Periodontol., roč. 42, 2015, č. 5, s. 407–412.

22. Jagannathachary, S., Kamaraj, D.: Obesity and periodontal disease. J. Indian Soc. Periodontol., roč. 14, 2010, č. 2, s. 96–100.

23. Jansson, H., Lindholm, E., Lindh, C.: Type 2 diabetes and risk for periodontal disease: a role for dental health awareness. J. Clin. Periodontol., roč. 33, 2006, č. 6, s. 408–414.

24. Khader, Y. S., Albashaireh, Z. S. M., Hammad, M. M.: Periodontal status of type 2 diabetics compared with nondiabetics in north Jordan. East Mediterr Health J Rev Santé Méditerranée Orient Al-Majallah Al-Sihhiyah Li-Sharq Al-Mutawassit, roč. 14, 2008, č. 3, s. 654–661.

25. Khader, Y. S., Dauod, A. S., El-Qaderi, S. S.: Periodontal status of diabetics compared with nondiabetics: a meta-analysis. J. Diabetes Complications, roč. 20, 2006, č. 1, s. 59–68.

26. Lalla, E., Kaplan, S., Chang, S. J.: Periodontal infection profiles in type 1 diabetes. J. Clin. Periodontol., roč. 33, 2006, č. 12, s. 855–862.

27. Lim, L. P., Tay, F. B. K., Sum, C. F., Thai, A. C.: Relationship between markers of metabolic control and inflammation on severity of periodontal disease in patients with diabetes mellitus. J Clin Periodontol, roč. 34, 2007, č. 2, s. 118–123.

28. Löe, H.: The gingival index, the plaque index and the retention index systems. J. Periodontol., roč. 38, 1967, suppl. 6, s. 610–616.

29. Löe, H.: Periodontal disease. The sixth complication of diabetes mellitus. Diabetes Care, roč. 16, 1993, č. 1, s. 329–334.

30. Mathur, L. K., Manohar, B., Shankarapillai, R., Pandya, D.: Obesity and periodontitis: a clinical study. J. Indian Soc. Periodontol., roč. 15, 2011, č. 3, s. 240–244.

31. Moore, P. A., Weyant, R. J., Mongelluzzo, M. B.: Type 1 diabetes mellitus and oral health: assessment of periodontal disease. J. Periodontol., roč. 70, 1999, č. 4, s. 409–417.

32. Morita, I., Okamoto, Y., Yoshii, S.: Five-year incidence of periodontal disease is related to body mass index. J. Dent. Res., roč. 90, 2011, č. 2, s. 199–202.

33. Nishida, N., Tanaka, M., Hayashi, N.: Determination of smoking and obesity as periodontitis risks using the classification and regression tree method. J. Periodontol., roč. 76, 2005, č. 6, s. 923–928.

34. Rajhans, N. S., Kohad, R. M., Chaudhari, V. G., Mhaske, N. H.: A clinical study of the relationship between diabetes mellitus and periodontal disease. J. Indian Soc. Periodontol., roč. 15, 2011, č.4, s. 388–392.

35. Sarem, I. A., Nelson, R. G., Tulloch-Reid, M.: Periodontal disease and mortality in type 2 diabetes. Diabetes Care, roč. 28, 2005, č. 1, s. 27-32.

36. Shultis, W. A., Weil, E. J., Looker, H. C.: Effect of periodontitis on overt nephropathy and end-stage renal disease in type 2 diabetes. Diabetes Care, roč. 30, 2007, č. 2, s. 306–311.

37. Soory, M.: Hormone mediation of immune responses in the progression of diabetes, rheumatoid arthritis and periodontal diseases. Curr. Drug Targets Immune Endocr. Metab. Disord., roč. 2, 2002, č. 1, s. 13–25.

38. Syrjälä, A. M. H., Ylöstalo, P., Niskanen, M. C., Knuuttila, M. L. E.: Role of smoking and HbA1c level in periodontitis among insulin-dependent diabetic patients. J. Clin. Periodontol., roč. 30, 2003, č. 10, s. 871–875.

39. Taylor, J. J., Preshaw, P. M., Lalla, E.: A review of the evidence for pathogenic mechanisms that may link periodontitis and diabetes. J. Clin. Periodontol., roč. 40, 2013, suppl. 14, s. 113–134.

40. Tsai, C., Hayes, C., Taylor, G. W.: Glycemic control of type 2 diabetes and severe periodontal disease in the US adult population. Community Dent. Oral Epidemiol., roč. 30, 2002, č. 3, s. 182–192.

41. Wiebe, C. B., Putnins, E. E.: The periodontal disease classification system of the American Academy of Periodontology – an update. J. Can. Dent. Assoc., roč. 66, 2000, č. 11, s. 594–597.

42. Yuan, K., Chang, C. J., Hsu, P. C.: Detection of putative periodontal pathogens in non-insulin-dependent diabetes mellitus and non-diabetes mellitus by polymerase chain reaction. J. Periodontal. Res., roč. 36, 2001, č. 1, s. 18–24.

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Article was published in

Czech Dental Journal

2018 Issue 1