Abstract
BackgroundPeriodontitis has been associated with diabetes and poor health. While clear associations have been identified for the diabetes–oral health link, less is known about the implications of poor oral health status for incident complications of diabetes. This study investigated the risk of diabetes complications associated with self-reported “poor to fair” and “good to excellent” oral health among diabetics living in Ontario, Canada.MethodsThis was a cohort study of diabetics who took part in the Canadian Community Health Survey (2003 and 2007–08). Self-reported oral health was linked to electronic health records held at the Institute for Clinical Evaluative Sciences. Participants aged 40 years and over, who self-reported oral health status in linked databases were included (N = 5,183). Cox proportional hazard models were constructed to determine the risk of diabetes complications. Participants who did not experience any complications were censored. Models were adjusted for age and sex, followed by social characteristics and behavioural factors. The population attributable risk of diabetes complications was calculated using fully adjusted hazard ratios.ResultsDiabetes complications differed by self-reported oral health; 35% of the total sample experienced a complication and 34% of those reporting “good to excellent” oral health (n = 4090) experienced a complication in comparison to 38% of those with “fair to poor” oral health (n = 1093). For those reporting “poor to fair” oral health, the hazard of a diabetes complication was 30% greater (HR 1.29; 95% CI: 1.03, 1.61) than those reporting “good to excellent” oral health. The population level risk of complications attributable to oral health was 5.2% (95% CI: 0.67, 8.74).ConclusionsOur findings indicate that reporting “poor to fair” oral health status may be attributed to health complications among diabetics, after adjusting for a wide range of confounders. This has important public health implications for diabetics in Ontario, Canada.
Highlights
Diabetes is one of the most prevalent chronic conditions and the sixth leading cause of mortality in Canada [1,2]
This study investigated the risk of diabetes complications associated with self-reported “poor to fair” and “good to excellent” oral health among diabetics living in Ontario, Canada
Institute for Clinical Evaluative Sciences (ICES) is authorized to disclose ICES data for research that is described in a research plan that meets the requirements of s. 44(2) of the Act and approved by a research ethics board, or in the Diabetes complications differed by self-reported oral health; 35% of the total sample experienced a complication and 34% of those reporting “good to excellent” oral health (n = 4090) experienced a complication in comparison to 38% of those with “fair to poor” oral health (n = 1093)
Summary
Diabetes is one of the most prevalent chronic conditions and the sixth leading cause of mortality in Canada [1,2]. Recent meta-analyses have reported that mild to moderate periodontal disease affects a majority of adults and that approximately 5–20% of any population suffers from its severest form [5,6,7]. Mild periodontal disease is characterized as an early manifestation of the condition and severe periodontal disease occurs as the result of a chronic state of disease. 6% of the general Canadian adult population have severe periodontal disease [8]. This study investigated the risk of diabetes complications associated with self-reported “poor to fair” and “good to excellent” oral health among diabetics living in Ontario, Canada
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