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Is Periodontal Disease Influenced by Diabetes Type?

Severity of periodontal disease between type 1 and type 2 diabetes patients….

Periodontal disease, and specifically periodontitis, is an inflammatory disease caused by a chronic bacterial presence that adhere and grow on the tooth surface. This can cause gingival (gum) bleeding, gingival recession, clinical attachment loss (teeth do not attach to gums as well), and the formation of periodontal pockets (spaces between the gum and tooth). A large number of studies have shown that periodontitis is more prevalent and severe in patients with diabetes than those without diabetes, and because of this diabetes has been cited as a significant risk factor for periodontal disease. The majority of research on this subject has been done between periodontal disease and either type 1 or type 2 diabetes, but there have not been any studies that evaluated the association between the severity of periodontal disease with respect to the type of diabetes.

A study was done in which patients aged 18-70 were evaluated. Two groups of patients were formed depending on their type of diabetes. A total of 179 randomly selected patients were in the group with type 1 diabetes and 87 randomly selected patients were in the type 2 diabetes group. Periodontal examinations were performed on all patients and were evaluated on 5 parameters: presence of dental plaque, pocket depth, gingival recession, clinical attachment level, and amount of bleeding on probing. The results of the examination showed that the relative values of the periodontal parameters were significantly higher in the type 2 diabetes group, which suggests that the type 2 diabetic group had more severe periodontal pathology than the type 1 group.

In conclusion, the risk of having severe periodontitis was twice as high for type 2 diabetics than type 1 diabetics. It should be noted that the patients with type 2 diabetes were significantly older than the type 1 diabetic patients, and previous studies of patients with diabetes have shown a negative correlation of periodontal state with age. Also, those in the group with type 2 diabetes have a longer duration of the disease than those with type 1 diabetes, which increases the risk of periodontitis. Despite this, the study has determined that dental plaque factor is the major contributing factor for not only diabetic patients, but all patients that suffer from periodontal disease.

Practice Pearls:
  • Periodontitis more pronounced in type 2 diabetics than type 1 diabetics.
  • Metabolic control as determined by A1c values has no significant influence on periodontal state in either diabetic type.

Pranckeviciene, A. et al. "Severity of periodontal disease in adult patients with diabetes mellitus in relation to the type of diabetes" Biomed Pap Med Fac Univ Olomouc Czech Repub. 2014; 158:XX 1-6. Diabetes/Metabolism Research & Reviews 2014