Oral hygiene: the third column of basal diabetes therapy

Schulze A2 , Busse M1

General Outpatient Ambulance1 and Sports Dentistry2 of the Institute of Sports Medicine & Prevention, University of Leipzig (1Director: Prof. M.W. Busse, MD) (2Head: A. Schulze, DDS)

Summary

Schulze A, Busse M. Oral hygiene: the third column of basal diabetes therapy. Clinical Sports Medicine International (CSMI) 2009, 3: 14-21.

Purpose:Diabetes is associated with increased prevalence and severity of periodontal inflammations. The aim was to examine the interrelationship among medical/periodontal variables and oral hygiene behaviour of type 2 diabetic and non-diabetic subjects to identify factors that may be predictors for periodontal disease.

Materials and methods:517 subjects (346 type 2 diabetic, 171 non-diabetic) underwent a clinical periodontal examination and completed an oral hygiene self-questionnaire. Screening parameters included the gingivitis (GI), papillary bleeding (PBI) and visible plaque (VPI) index, periodontal screening and recording (PSR), probing pocket depth (PPD). Anthropometric and diabetes parameters were also measured.

Results:Periodontal health indicators were significantly better in non-diabetics. Diabetic patients had significantly fewer teeth (minus 9.8% or 12.5% in patients with oral or insulin therapy), worse oral hygiene and the GI and PSR scores were significantly higher (GI score: plus 33% and 42% in patients with oral or insulin therapy; PSR score: plus 35% in diabetic patients). The percentage of papillary bleeding was also higher in diabetic patients (58% and 63% in patients with oral or insulin therapy vs. 51% in non-diabetics). The visible plaque index was significantly correlated with periodontal parameters.

Conclusion: Diabetes is related to increased levels of periodontal inflammation scores, which showed a strong correlation to the plaque. We suggest that the relation between periodontitis and diabetes may have an important link in a minor oral hygiene. Therefore, like diabetes type 2 itself, this relation mainly may be due to behaviour characteristics.

Keywords: diabetes, periodontal disease, oral hygiene