Effect of glycemic control on periodontal disease and caries experience in diabetic patients: A pilot study

Abstract

Background: Diabetes mellitus is a diverse set of metabolic disorders initiated by either a lack of insulin, opposition to its action, or both. The aim of this study was to assess the association between glycemic control and the periodontal/caries status of controlled diabetic patients at Lagos State University Teaching Hospital, Ikeja. Materials and Methods: Forty-eight diabetic patients with good glycemic control demonstrated by three consecutive results in their medical records and who gave informed consent were enlisted and screened for periodontal disease and dental caries. Glycemic control was assessed using fasting blood sugar, 2-h postprandial, and glycated hemoglobin (Hb1Ac). Caries was assessed by decayed missing filled teeth (DMFT) while oral hygiene index, gingival index (GI), clinical attachment loss (CAL), and probing pocket depth (PPD) were used to assess periodontal health. The data collected were analyzed using SPSS version 18 and test of statistical significance was done using Chi-square test and ANOVA test. A P ≤ 0.05 was recorded as statistically significant. Results: The PPD and CAL of the participants were significantly associated with their glycemic levels. Those with increased glycemic values had greater attachment loss and pocket depth. Gingival inflammation and oral hygiene were however not significantly associated with glycemic control. Respondents above 65 years similarly had significantly higher numbers of missing teeth (P = 0.04) and greater mean DMFT values (P = 0.03). Similarly, respondents above 66 years of age, those who had no education, and females were observed to have worse oral hygiene, gingival inflammation, and periodontal destruction evidenced by CAL and PPD than other respondents, even though the association was not significant. Conclusion: Oral health manifestations of diabetes need to be emphasized like other systemic diabetic complications. The salient role of glycemic control in periodontal health should also be continuously emphasized among diabetics.