Long‐term control of diabetes mellitus and periodontitis

Abstract

Abstract The purpose of this study was to evaluate the association between long‐term control of diabetes mellitus (DM) and periodontitis, A total of 75 diabetics (Type I or II) aged 20–70 years with long‐term records of their diabetic control were selected for the study. The following periodontal variables were recorded in a randomized half‐mouth examination: plaque, calculus (+/−), probing depth (pd) and attachment loss (al). The mean of glycosylated hemoglobin measurements (IIbAlc) over the past 2–5 years was used to indicate the long‐term control of DM. The study participants were divided into well‐, moderately‐ and poorly‐controlled diabetics. An increase in the prevalence, severity and extent of periodontitis with poorer control of diabetes was observed. The extent of calculus also increased with poorer control. In a multiple regression analysis, calculus and long‐term control of diabetes were significant variables when pd≥4 mm was used as the dependent variable. Age was a significant predictor for al > 3 mm but not for pd ≥4 mm. Sex, duration and type of DM were not significant variables in the regression models. Less than 2% of sites with no calculus demonstrated pd≥4mm. When calculus was present, the frequency of pd ≥4 mm increased from 6% in the well‐controlled diabetics to 16% in the poorly‐controlled ones. We conclude that periodontitis in diabetics is associated with long‐term metabolic control and presence of calculus. Therefore, regular maintenance care, including patient motivation and instruction as well as professional calculus removal, is important for diabetic patients.