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Published in: BMC Oral Health 1/2023

Open Access 01-12-2023 | Diabetes | Research

Association and comparison of periodontal and oral hygiene status with serum HbA1c levels: a cross-sectional study

Authors: Abid Rahim, Sabreen Hassan, Naeem Ullah, Nawal Noor, Ahmed, Rimsha Rafique, Farhad Ali Khattak, Saima Afaq

Published in: BMC Oral Health | Issue 1/2023

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Abstract

Background

Diabetes Mellitus and periodontitis are chronic diseases with known reciprocal association. Studies have shown that uncontrolled diabetes increases the risk of development and progression of periodontal disease. This study aimed to explore the association and severity of periodontal clinical parameters and oral hygiene with HbA1c levels in non-diabetics and T2DM patients.

Materials and methods

In this cross-sectional study, the periodontal status of 144 participants, categorized into non-diabetics, controlled T2DM, and uncontrolled T2DM and were assessed via the Community Periodontal Index (CPI), Loss of Attachment Index (LOA index), and the number of missing teeth, while oral hygiene was measured by utilizing the Oral Hygiene Index Simplified (OHI-S). SPSS was used for data analysis. Chi-square test was used to find out the association of different independent variables with HbA1c groups, while ANOVA and post-hoc tests were run for inter-group and intra-group comparison respectively.

Results

Out of 144 participants, the missing dentition was prevalent in uncontrolled T2DM with mean 2.64 ± 1.97 (95% CI 2.07–3.21; p = 0.01) followed by controlled T2DM 1.70 ± 1.79 (95% CI 1.18–2.23; p = 0.01) and non-diabetics 1.35 ± 1.63 (95% CI 0.88–1.82; p = 0.01) respectively. Furthermore, non-diabetics had a higher proportion of CPI score 0 (Healthy) [30 (20.8%); p = 0.001] as compared to uncontrolled T2DM [6 (4.2%); p = 0.001], while CPI score 3 was more prevalent in uncontrolled T2DM in comparison to non-diabetics. Loss of attachment (codes-2,3 and 4) was also frequently observed in uncontrolled T2DM compared to non-diabetics (p = 0.001). Similarly, based on Oral Hygiene Index- Simplified (OHI-S), the result showed that poor oral hygiene was most commonly observed in uncontrolled T2DM 29 (20.1%) followed by controlled T2DM patients 22 (15.3%) and non-diabetic [14 (9.7%); p = 0.03].

Conclusion

This study showed that periodontal status and oral hygiene status were deteriorated in uncontrolled T2DM patients compared to non-diabetic participants and controlled T2DM.
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Literature
1.
go back to reference Slots J. Periodontitis: facts, fallacies and the future. Periodontol 2000. 2017;75(1):7–23. Slots J. Periodontitis: facts, fallacies and the future. Periodontol 2000. 2017;75(1):7–23.
2.
go back to reference Thornton-Evans G, Eke P, Wei L, Palmer A, Moeti R, Hutchins S, et al. Periodontitis among adults aged ≥ 30 years - United States, 2009–2010. MMWR Suppl. 2013;22(3):129–35. Thornton-Evans G, Eke P, Wei L, Palmer A, Moeti R, Hutchins S, et al. Periodontitis among adults aged ≥ 30 years - United States, 2009–2010. MMWR Suppl. 2013;22(3):129–35.
4.
go back to reference Hajishengallis G, Chavakis T. Local and systemic mechanisms linking periodontal disease and inflammatory comorbidities. Nat Rev Immunol 2021;21(7):426–40. Hajishengallis G, Chavakis T. Local and systemic mechanisms linking periodontal disease and inflammatory comorbidities. Nat Rev Immunol 2021;21(7):426–40.
5.
go back to reference Isola G, Santonocito S, Distefano A, Polizzi A, Vaccaro M, Raciti G et al. Impact of periodontitis on gingival crevicular fluid miRNAs profiles associated with cardiovascular disease risk. J Periodontal Res 2023 Feb 8;58(1):165–74. Isola G, Santonocito S, Distefano A, Polizzi A, Vaccaro M, Raciti G et al. Impact of periodontitis on gingival crevicular fluid miRNAs profiles associated with cardiovascular disease risk. J Periodontal Res 2023 Feb 8;58(1):165–74.
6.
go back to reference Isola G, Giudice A, Lo, Polizzi A, Alibrandi A, Patini R, Ferlito S. Periodontitis and Tooth Loss Have Negative Systemic Impact on Circulating Progenitor Cell Levels: A Clinical Study. Genes (Basel). 2019;10(12):01–12. Isola G, Giudice A, Lo, Polizzi A, Alibrandi A, Patini R, Ferlito S. Periodontitis and Tooth Loss Have Negative Systemic Impact on Circulating Progenitor Cell Levels: A Clinical Study. Genes (Basel). 2019;10(12):01–12.
7.
go back to reference Ronnie Levine, Catherine Stillman-Lowe. The scientific basis of oral Health Education (BDJ Clinician’s Guides). 8th ed. Springer; 2018. Ronnie Levine, Catherine Stillman-Lowe. The scientific basis of oral Health Education (BDJ Clinician’s Guides). 8th ed. Springer; 2018.
9.
go back to reference Lertpimonchai A, Rattanasiri S, Arj-Ong Vallibhakara S, Attia J, Thakkinstian A. The association between oral hygiene and periodontitis: a systematic review and meta-analysis. Int Dent J [Internet]. 2017 Dec 1 [cited 2023 Apr 9];67(6):332–43. Available from: https://pubmed.ncbi.nlm.nih.gov/28646499/. Lertpimonchai A, Rattanasiri S, Arj-Ong Vallibhakara S, Attia J, Thakkinstian A. The association between oral hygiene and periodontitis: a systematic review and meta-analysis. Int Dent J [Internet]. 2017 Dec 1 [cited 2023 Apr 9];67(6):332–43. Available from: https://​pubmed.​ncbi.​nlm.​nih.​gov/​28646499/​.
11.
go back to reference Khan MAB, Hashim MJ, King JK, Govender RD, Mustafa H, Al Kaabi J. Epidemiology of type 2 diabetes – global burden of Disease and Forecasted Trends. J Epidemiol Glob Health. 2019;10(1):107–11.CrossRef Khan MAB, Hashim MJ, King JK, Govender RD, Mustafa H, Al Kaabi J. Epidemiology of type 2 diabetes – global burden of Disease and Forecasted Trends. J Epidemiol Glob Health. 2019;10(1):107–11.CrossRef
12.
go back to reference Khader YS, Dauod AS, El-Qaderi SS, Alkafajei A, Batayha WQ. Periodontal status of diabetics compared with nondiabetics: a meta-analysis. J Diabetes Complications. 2006;20(1):59–68. Khader YS, Dauod AS, El-Qaderi SS, Alkafajei A, Batayha WQ. Periodontal status of diabetics compared with nondiabetics: a meta-analysis. J Diabetes Complications. 2006;20(1):59–68.
13.
go back to reference Genco RJ, Grossi SG, Ho A, Nishimura F, Murayama Y. A proposed model linking inflammation to obesity, diabetes, and Periodontal Infections. J Periodontol. 2005;76(11–s):2075–84. Genco RJ, Grossi SG, Ho A, Nishimura F, Murayama Y. A proposed model linking inflammation to obesity, diabetes, and Periodontal Infections. J Periodontol. 2005;76(11–s):2075–84.
14.
go back to reference Preshaw PM, Taylor JJ, Jaedicke KM, De Jager M, Bikker JW, Selten W et al. Treatment of periodontitis reduces systemic inflammation in type 2 diabetes. J Clin Periodontol. 2020;47(6):737–46. Preshaw PM, Taylor JJ, Jaedicke KM, De Jager M, Bikker JW, Selten W et al. Treatment of periodontitis reduces systemic inflammation in type 2 diabetes. J Clin Periodontol. 2020;47(6):737–46.
15.
go back to reference Pattayil S, Vadakkekuttical RJ, Radhakrishnan C, Kanakkath H, Hrishi TS. Proportional relationship between periodontal inflamed surface area, clinical attachment loss, and glycated hemoglobin level in patients with type 2 diabetes mellitus on insulin therapy and on oral antidiabetic therapy. J Periodontol. 2023;3(1):31–40. Pattayil S, Vadakkekuttical RJ, Radhakrishnan C, Kanakkath H, Hrishi TS. Proportional relationship between periodontal inflamed surface area, clinical attachment loss, and glycated hemoglobin level in patients with type 2 diabetes mellitus on insulin therapy and on oral antidiabetic therapy. J Periodontol. 2023;3(1):31–40.
16.
go back to reference Banjar A, Alyafi R, AlGhamdi A, Assaggaf M, Almarghlani A, Hassan S et al. The relationship between glycated hemoglobin level and the stage of periodontitis in individuals without diabetes. PLoS One 2023;18(1):e0279755. Banjar A, Alyafi R, AlGhamdi A, Assaggaf M, Almarghlani A, Hassan S et al. The relationship between glycated hemoglobin level and the stage of periodontitis in individuals without diabetes. PLoS One 2023;18(1):e0279755.
17.
go back to reference Zhang X, Wang M, Wang X, Qu H, Zhang R, Gu J et al. Relationship between periodontitis and microangiopathy in type 2 diabetes mellitus: a meta-analysis. J Periodontal Res 2021;56(6):1019–27. Zhang X, Wang M, Wang X, Qu H, Zhang R, Gu J et al. Relationship between periodontitis and microangiopathy in type 2 diabetes mellitus: a meta-analysis. J Periodontal Res 2021;56(6):1019–27.
18.
go back to reference Kesavan R, Chaly P, Reddy Vc M, Av. Periodontal status among type II diabetic and nondiabetic individuals in Chennai, India: a comparative study. J Indian Association Public Health Dentistry. 2015;13(4):393–8. Kesavan R, Chaly P, Reddy Vc M, Av. Periodontal status among type II diabetic and nondiabetic individuals in Chennai, India: a comparative study. J Indian Association Public Health Dentistry. 2015;13(4):393–8.
21.
go back to reference Kim EK, Lee SG, Choi YH, Won KC, Moon JS, Merchant AT et al. Association between diabetes-related factors and clinical periodontal parameters in type-2 diabetes mellitus. BMC Oral Health 2013;13(1):1–8. Kim EK, Lee SG, Choi YH, Won KC, Moon JS, Merchant AT et al. Association between diabetes-related factors and clinical periodontal parameters in type-2 diabetes mellitus. BMC Oral Health 2013;13(1):1–8.
22.
go back to reference Apoorva S, 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. 2013;17(1):25–9. Apoorva S, 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. 2013;17(1):25–9.
23.
go back to reference Khader YS, Albashaireh ZSM, Hammad MM. Periodontal status of type 2 diabetics compared with nondiabetics in north Jordan. East Mediterr Health J. 2008;14(3):654–61.PubMed Khader YS, Albashaireh ZSM, Hammad MM. Periodontal status of type 2 diabetics compared with nondiabetics in north Jordan. East Mediterr Health J. 2008;14(3):654–61.PubMed
25.
go back to reference Javed F, Näsström K, Benchimol D, Altamash M, Klinge B, Engström PE. Comparison of Periodontal and Socioeconomic Status between subjects with type 2 diabetes Mellitus and non-diabetic controls. J Periodontol. 2007;78(11):2112–9. Javed F, Näsström K, Benchimol D, Altamash M, Klinge B, Engström PE. Comparison of Periodontal and Socioeconomic Status between subjects with type 2 diabetes Mellitus and non-diabetic controls. J Periodontol. 2007;78(11):2112–9.
26.
go back to reference Chee B, Park B, Bartold MP. Periodontitis and type II diabetes: a two-way relationship. Int J Evid Based Healthc. 2013;11(4):317–29. Chee B, Park B, Bartold MP. Periodontitis and type II diabetes: a two-way relationship. Int J Evid Based Healthc. 2013;11(4):317–29.
27.
go back to reference Lalla E, Papapanou PN. Diabetes mellitus and periodontitis: a tale of two common interrelated diseases. Nat Rev Endocrinol 2011;7(12):738–48. Lalla E, Papapanou PN. Diabetes mellitus and periodontitis: a tale of two common interrelated diseases. Nat Rev Endocrinol 2011;7(12):738–48.
28.
go back to reference Teles F, Wang Y, Hajishengallis G, Hasturk H, Marchesan JT. Impact of systemic factors in shaping the periodontal microbiome. Periodontol 2000. 2021;85(1):126–60. Teles F, Wang Y, Hajishengallis G, Hasturk H, Marchesan JT. Impact of systemic factors in shaping the periodontal microbiome. Periodontol 2000. 2021;85(1):126–60.
29.
go back to reference Wu C, Yuan Y hang, Liu H hang, Li S sui, Zhang B wen, Chen W et al. Epidemiologic relationship between periodontitis and type 2 diabetes mellitus. BMC Oral Health. 2020;20(1):01–15. Wu C, Yuan Y hang, Liu H hang, Li S sui, Zhang B wen, Chen W et al. Epidemiologic relationship between periodontitis and type 2 diabetes mellitus. BMC Oral Health. 2020;20(1):01–15.
30.
go back to reference Preshaw PM, Alba AL, Herrera D, Jepsen S, Konstantinidis A, Makrilakis K et al. Periodontitis and diabetes: a two-way relationship. Diabetologia 2012;55(1):21–31. Preshaw PM, Alba AL, Herrera D, Jepsen S, Konstantinidis A, Makrilakis K et al. Periodontitis and diabetes: a two-way relationship. Diabetologia 2012;55(1):21–31.
31.
go back to reference Buranasin P, Mizutani K, Iwasaki K, Pawaputanon Na Mahasarakham C, Kido D, Takeda K et al. High glucose-induced oxidative stress impairs proliferation and migration of human gingival fibroblasts. PLoS One. 2018;13(8):e0201855. Buranasin P, Mizutani K, Iwasaki K, Pawaputanon Na Mahasarakham C, Kido D, Takeda K et al. High glucose-induced oxidative stress impairs proliferation and migration of human gingival fibroblasts. PLoS One. 2018;13(8):e0201855.
32.
go back to reference Sandini Trentin M, De João; P, De M, Ferreira C, Diego ;, et al. Prevalence and Severity of Periodontal Disease in Type 2 Diabetes Mellitus Patients: a Cross-Sectional Study. Biosci J. 2018;4(34):1114–23. Sandini Trentin M, De João; P, De M, Ferreira C, Diego ;, et al. Prevalence and Severity of Periodontal Disease in Type 2 Diabetes Mellitus Patients: a Cross-Sectional Study. Biosci J. 2018;4(34):1114–23.
34.
go back to reference Pabisch S, Akabane C, Wagermaier W, Roschger A, Ogura T, Hyodo R, et al. The nanostructure of murine alveolar bone and its changes due to type 2 diabetes. J Struct Biol. 2016;196(2):223–31. Pabisch S, Akabane C, Wagermaier W, Roschger A, Ogura T, Hyodo R, et al. The nanostructure of murine alveolar bone and its changes due to type 2 diabetes. J Struct Biol. 2016;196(2):223–31.
35.
go back to reference Farooq A, Riasat M, Baloch HKN, Shah SGS, Shehzad S, Shah SZEHS. Severity of alveolar bone loss in control and uncontrolled type II diabetics. Pakistan J Med Health Sci 2021;15(6):1459–62. Farooq A, Riasat M, Baloch HKN, Shah SGS, Shehzad S, Shah SZEHS. Severity of alveolar bone loss in control and uncontrolled type II diabetics. Pakistan J Med Health Sci 2021;15(6):1459–62.
36.
go back to reference Hintao J, Teanpaisan R, Chongsuvivatwong V, Dahlen G, Rattarasarn C. Root surface and coronal caries in adults with type 2 diabetes mellitus. Community Dent Oral Epidemiol. 2007;35(4):302–9. Hintao J, Teanpaisan R, Chongsuvivatwong V, Dahlen G, Rattarasarn C. Root surface and coronal caries in adults with type 2 diabetes mellitus. Community Dent Oral Epidemiol. 2007;35(4):302–9.
37.
go back to reference Chang Y, Lee JS, Lee KJ, Woo HG, Song TJ. Improved oral hygiene is associated with decreased risk of new-onset diabetes: a nationwide population-based cohort study. Diabetologia. 2020;63(2):924–33. Chang Y, Lee JS, Lee KJ, Woo HG, Song TJ. Improved oral hygiene is associated with decreased risk of new-onset diabetes: a nationwide population-based cohort study. Diabetologia. 2020;63(2):924–33.
38.
go back to reference Fu W, Lv C, Zou L, Song F, Zeng X, Wang C et al. Meta-analysis on the association between the frequency of tooth brushing and diabetes mellitus risk. Diabetes Metab Res Rev 2019;35(5):e3141. Fu W, Lv C, Zou L, Song F, Zeng X, Wang C et al. Meta-analysis on the association between the frequency of tooth brushing and diabetes mellitus risk. Diabetes Metab Res Rev 2019;35(5):e3141.
39.
go back to reference Nishihara U, Tanabe N, Nakamura T, Okada Y, Nishida T, Akihara S. A periodontal disease care program for patients with type 2 diabetes: a randomized controlled trial. J Gen Fam Med. 2017;18(5):249–57. Nishihara U, Tanabe N, Nakamura T, Okada Y, Nishida T, Akihara S. A periodontal disease care program for patients with type 2 diabetes: a randomized controlled trial. J Gen Fam Med. 2017;18(5):249–57.
40.
go back to reference Greenblatt AP, Salazar CR, Northridge ME, Kaplan RC, Taylor GW, Finlayson TL et al. Association of diabetes with tooth loss in Hispanic/Latino adults: findings from the Hispanic Community Health Study/Study of Latinos. BMJ Open Diabetes Res Care. 2016;4(1):e000211. Greenblatt AP, Salazar CR, Northridge ME, Kaplan RC, Taylor GW, Finlayson TL et al. Association of diabetes with tooth loss in Hispanic/Latino adults: findings from the Hispanic Community Health Study/Study of Latinos. BMJ Open Diabetes Res Care. 2016;4(1):e000211.
Metadata
Title
Association and comparison of periodontal and oral hygiene status with serum HbA1c levels: a cross-sectional study
Authors
Abid Rahim
Sabreen Hassan
Naeem Ullah
Nawal Noor
Ahmed
Rimsha Rafique
Farhad Ali Khattak
Saima Afaq
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-023-03042-7

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