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Periodontal Disease Predicts Mortality in Diabetics

Those with severe periodontal disease had a 28.4 % death rate and those with no or little periodontal disease had a 3.7% death rate.

The results of a study published in the January issue of Diabetes Care suggest that periodontal disease is strongly predictive of mortality from ischemic heart disease and diabetic nephropathy in Pima Indians with type 2 diabetes.

In a prospective longitudinal study, Dr. Robert G. Nelson, of the National Institute of Diabetes and Digestive and Kidney Disease, Phoenix, Arizona, and colleagues examined the effect of periodontal disease on overall and cardiovascular disease mortality in 628 Pima Indians 35 years of age or older with type 2 diabetes.

The team used panoramic radiographs and clinical dental examinations to classify periodontal abnormality as none, mild, moderate, or severe. Overall, nearly 60% of the subjects had severe periodontal disease. Of these, 263 (70%) were edentulous.
A total of 204 subjects died during a median follow-up of 11 years. Forty-four of the 54 cardiovascular disease-related deaths were attributed to ischemic heart disease. Twenty-eight of the 35 diabetes-related deaths were attributed to diabetic nephropathy.

"The age- and sex-adjusted death rates for all natural causes expressed as the number of deaths per 1000 person-years of follow-up were 3.7 for no or mild periodontal disease, 19.6 for moderate disease, and 28.4 for severe periodontal disease," they report.

Periodontal disease was predictive of mortality from ischemic heart disease (p trend = 0.04) and diabetic nephropathy (p trend < 0.01). No association was observed between death rates from other causes and periodontal disease.

"Periodontal disease is a major public health burden in Pima Indians, and it is a strong predictor of death from cardiorenal disease in those with type 2 diabetes," the researchers conclude.
Diabetes Care 2005;28:27-32.

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