Prevalence Of Periodontitis In Patients With Controlled And Uncontrolled Diabetes Mellitus
Jitesh S1, Arvina Rajasekar2*, Madhulaxmi M3
1 Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences(SIMATS), Saveetha University, Chennai 600077, TamilNadu, India.
2 Senior Lecturer, Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences(SIMATS), Saveetha University, Chennai 600077, Tamil Nadu, India.
3 Professor, Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences(SIMATS), Saveetha University, Chennai 600077, Tamil Nadu, India.
*Corresponding Author
Arvina Rajasekar,
Senior Lecturer, Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences(SIMATS), Saveetha University, Chennai
600077, Tamil Nadu, India.
Tel: +91 9486442309
E-mail: arvinar.sdc@saveetha.com
Received: July 30, 2021; Accepted: August 11, 2021; Published: August 18, 2021
Citation:Jitesh S, Arvina Rajasekar, Madhulaxmi M. Prevalence Of Periodontitis In Patients With Controlled And Uncontrolled Diabetes Mellitus. Int J Dentistry Oral Sci. 2021;8(8):4070-4073. doi: dx.doi.org/10.19070/2377-8075-21000831
Copyright: Arvina Rajasekar©2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
Diabetes mellitus is recognized as an important risk factor for more severe and progressive periodontitis, infection or lesions resulting in the destruction of tissues and supporting bone that form the attachment around the tooth. Periodontal disease has been reported as the sixth complication of diabetes mellitus, along with neuropathy, nephropathy, retinopathy, and microand macrovascular diseases. The main objective was to find out the prevalence of periodontitis in patients with controlled and uncontrolled diabetes mellitus (DM). This is an institutional based retrospective study conducted among 100 outpatients with controlled DM and 100 patients with uncontrolled DM who reported to Private Dental College and Hospitals, Chennai from June 2019 to March 2020. Data regarding the periodontal status was collected and analysed. Differential and inferential statistics were done for data summarization and presentation. The present study showed that out of 200 patients with DM, 50 (25%) had gingivitis and 150 (75%) had periodontitis. Also, periodontitis was more prevalent in patients with uncontrolled DM (91%) than patients with controlled DM (59%). There was a statistically significant association between systemic health status and periodontal disease status. Within the limits of the present study, periodontitis was more prevalent in patients with uncontrolled DM than patients with controlled DM.
2.Introduction
3.Conclusion
4.References
Keywords
Diabetes Mellitus; Gingivitis; Oral Health; Periodontitis; Periodontium.
Introduction
Diabetes mellitus is a clinically and genetically heterogeneous
group of disorders affecting the metabolism of carbohydrates,
lipids and a protein, in which hyperglycemia is a main feature.
These disorders are due to a deficiency in insulin secretion caused
by pancreatic ß-cell dysfunction and/or insulin resistance in liver
and muscle.[48, 38]. Diabetes mellitus affects about 21 million
people in the United States, or more than 9% of the adult population,
and has a dramatic impact on the health care system through
high morbidity and mortality among affected individuals [24, 50].
In Ontario, population-based data have revealed that the prevalence
of diabetes mellitus increased by 69% over a recent 10-year
period (from 5.2% in 1995 to 8.8% in 2005), which exceeded the
global rate of increase of 39% that was predicted for the period
2000 to 2030. Furthermore, the rates of increase rose to a greater
extent in the younger population. This increase was attributable to
both a rise in incidence and a decline in mortality [4, 20, 29]. Similarly,
in the First Nations community of Kahnawake, Quebec, the
prevalence rates of type 2 diabetes mellitus increased over the
period 1986 to 2003, from 6.0% to 8.4% among males and from
6.4% to 7.1% among females [14].
Diabetes mellitus is a heterogeneous group of disorders with different
causes but all characterized by hyperglycemia. Type 1 diabetes
mellitus is due to destruction of the insulin-producing cells.
Type 2 diabetes mellitus is the result of insulin resistance coupled
with relative beta-cell failure [12].
Periodontitis is a chronic inflammatory disease affecting both
soft and hard tissues of oral cavity. The primary etiology of the
disease is bacterial plaque however the disease is modified by a variety of risk factors like age, gender, smoking, stress, systemic
diseases, malnutrition, medication and genetic factors[25,18,42].
Numerous studies discusses the relationship between periodontitis
and type 2 diabetes mellitus, focusing on the mechanisms
through which periodontal infections contribute to the diabetes
mellitus-related inflammatory state, the influence of periodontal
infections on insulin resistance and the ways in which treatment
of these infections can influence glycemic control [7, 17, 22].
Diabetes mellitus is recognized as an important risk factor for
more severe and progressive periodontitis, infection or lesions
resulting in the destruction of tissues and supporting bone that
form the attachment around the tooth [15, 38, 41]. Periodontal
disease has been reported as the sixth complication of diabetes
mellitus, along with neuropathy, nephropathy, retinopathy, and
micro- and macrovascular diseases [21]. It is well proved that
there exists a dual relationship between periodontitis and diabetes
[33, 40]. Previously our team has a rich experience in working on
various research projects across multiple disciplines [2, 8, 10, 11,
13, 26-28, 30, 31, 35, 45, 53]. Now the growing trend in this area
motivated us to pursue this project.
The purpose of this retrospective study was to determine the
prevalence of periodontitis in patients with controlled DM and
uncontrolled DM among the Chennai population.
Materials and Methods
This retrospective study was undertaken using a convenience
sample of 200 patients with diabetes mellitus reported to Private
Dental College and Hospitals, Chennai from June 2019 to March
2020. They were categorized into patients with controlled diabetes
mellitus (n=100) and uncontrolled diabetes mellitus (n=100).
Data regarding their periodontal status was collected and was analyzed.
Ethical approval for the study was obtained from Saveetha
University Ethical Review Board(SDC/SIHEC/2020/DIASDATA/
0619-0320).
Results & Discussion
Data collected were entered in SPSS version 20 and was subjected
to statistical analysis. Differential and inferential statistics were
done for data summarization and presentation. Results were tabulated
and represented graphically. The present study showed that
out of 200 patients with DM, 50 (25%) had gingivitis and 150
(75%) had periodontitis (Figure 1). Also, periodontitis was more
prevalent in patients with uncontrolled DM (91%) than patients
with controlled DM (59%) (Figure 2). There was a statistically
significant association between systemic health status and periodontal
disease status (Pearson’s Chi-Square test - 27.307, df - 1 ,
p=0.000 (p<0.05) ; statistically significant)(Figure 2).
DM and periodontitis are chronic diseases with a higher incidence
at increased age. Both of the morbidities negatively affect periodontal
health and systemic health, thus affecting the quality of
life [5]. An abundance of recent evidence has consolidated a bidirectional
correlation between diabetes and periodontitis. While
diabetes is an independent risk factor for periodontitis[47], periodontitis
as a chronic inflammation has a negative impact on the
metabolic control of diabetes [12]. In particular, periodontitis
ranks sixth among all complications of diabetes [21].
The global prevalence of DM is increasing in an accelerated manner;
the number of deaths per year as a result of diabetic complications
is about 5 million, which is significantly higher than the
number of deaths per year from AIDS, tuberculosis, and malaria
[3].
In this study, among 100 controlled DM patients, 41% were gingivitis
and 59% were periodontitis and among 100 patients with uncontrolled DM, 9% were gingivitis and 91% were periodontitis.
Our study showed that prevalence of periodontitis in patients
with uncontrolled DM were more than patients with controlled
DM .Similar results were observed in previous studies. Alshwaimi
E et al shows the association between diabetes mellitus and periodontal
disease [1]. Sut yee tse et al showed that dental practitioners
showed increased awareness about the association between
diabetes mellitus and periodontal disease [49]. Ying ying wu et
al showed that diabetes mellitus can cause bone related metabolism
and periodontal disease [54, 36]. Our institution is passionate
about high quality evidence based research and has excelled in
various fields [6, 9, 23, 32, 34, 39, 44, 46, 51, 52]. We hope this
study adds to this rich legacy.
The limitation of this study is its smaller sample size. A similar
study should be conducted on a larger scale involving a large
number of samples for more reliable results. Therefore, extensive
long-term studies need to be conducted to assess the periodontal
status of the diabetic patients.
Figure 1: Bar chart depicts the distribution of periodontal disease among the study population. X axis represents the periodontal disease status and Y axis represents the percentage of study population. 25% of them had gingivitis (blue) and 75% of them had periodontitis (red).
Figure 2: Bar chart depicts the association between systemic health status and periodontal disease status. X axis represents the systemic disease status and Y axis represents the percentage of number of patients suffering from periodontal disease. Among patients with uncontrolled DM, 91% had periodontitis(red) and 9% had gingivitis(blue) whereas among patients with controlled DM , 59% had periodontitis and 41% had gingivitis. There was a significant association between systemic health status and periodontal disease status as determined by Pearson’s Chi-Square test. (Pearson’s Chi-Square test - 27.307, df - 1 , p=0.000 (p<0.05); statistically significant).
Conclusion
The authors of this study would like to express their gratitude
towards everyone who facilitated and enabled us to carry out this
study successfully.
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