The normal glucose-tolerance pattern: Development of blood glucose normality by an analysis of oral roentgenographic findings

Abstract

1. 1. On the basis of the over-all glucose-tolerance pattern, 100 routine dental patients appear normal if judged by the standards for glucose established by Mosenthal and Barry. 2. 2. From an analysis of the mean two-hour determination of the glucose-tolerance pattern, 100 routine dental patients would be regarded as systemically abnormal. 3. 3. Alveolar bone loss in contrast to periodontal widening appears to be more related to diabetes mellitus. 4. 4. The combination of periodontal widening and alveolar bone loss seems to be more representative of the diabetic patient than independent analysis of these two roentgenographic findings. 5. 5. Within the limits of this study, the evidence suggests that the age factor does play a role in the relationship between alveolar bone loss and glucose metabolism. In the 20- to 29-year age group, the relationship of alveolar bone loss to carbohydrate metabolism is essentially the same as that observed for the entire group. It would have been desirable to study this relationship in older age groups also, but the samples did not permit statistieal analysis. 6. 6. Under the conditions of this study, the evidence suggests that the age factor seems to play a role in the relationship of periodontal widening to carbohydrate metabolism. In the 20- to 29-year-old patiets, the groups with and without periodontal widening were statistically different at the three-hour measurement. In contrast, for the entire group there was no statistically significant difference. A further analysis of older age groups, however, shows a loss of statistical significance. This can be interpreted to mean that, with age, other factors enter the picture which cancel out the relationship between periodontal widening and carbohydrate metabolism. 7. 7. The literature suggests that the number of teeth is an etiological factor in the development of periodontal widening and alveolar bone loss. We studied the relationship between these two roentgenographic findings, keeping the number of teeth constant. The evidence suggests that the group with periodontal widening and alveolar bone loss was significantly different from the group with no periodontal widening and no alveolar bone loss at the fasting and two-hour determinations. In other words, the statistical significance of the relationship of these two groups decreased when the number of teeth was kept constant. This can be interpreted to mean that the number of teeth operates in the relationship with these roentgenographic findings. However, the number of teeth is not the only factor. More important, it is not significant enough to destroy the correlation between periodontal widening and alveolar bone loss with carbohydrate metabolism. 8. 8. The literature suggests that calculus may play a role in the development of periodontal widening and alveolar bone loss. Accordingly, the patients were divided into two groups, with and without periodontal widening and alveolar bone loss, and at the same time the calculus factor was kept either absent or present. The evidence suggests that in the group without calculus the glucose-tolerance patterns of those with periodontal widening and alveolar bone loss were statistically distinct when compared with the glucose-tolerance patterns of the group in which those two roentgenographic findings were not seen at the two-hour determination. On the other hand, a similar analysis of the patients with calculus showed statistically significant differences between the groups at fasting, one hour, two hours, and three hours. These findings indicate that calculus is a factor in the relationship with periodontal widening and alveolar bone loss. It is not the only one, however, nor is it dominant enough in itself to destroy the correlation observed between these roentgenographic findings and glucose metabolism.