Epidemiological survey of periodontal health in patients with type 2 diabetes mellitus of different ages

doi:10.3969/j.issn.1674-8115.2021.02.014

Abstract

Abstract: Objective

·To investigate the periodontal health status of different age groups with type 2 diabetes mellitus, and to explore the influence of age on the prevalence of periodontitis in diabetic patients and the related risk factors.

Methods

·Periodontal examination and questionnaire survey were conducted on patients with type 2 diabetes mellitus who visited the Department of Endocrinology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University from November 2018 to December 2018. The periodontal indexes of index teeth were examined and scored, including probing depth, bleeding on probing, clinical attachment loss (CAL), calculus index (CI) and plaque index (PLI). According to the diagnostic criteria of periodontitis, the subjects were divided into periodontitis group and non-periodontitis group. The prevalence of periodontitis and related periodontal indexes in patients with type 2 diabetes mellitus of different ages were compared.

Results

·In the 916 patients with type 2 diabetes mellitus, the difference of age between the periodontitis group and non-periodontitis group was statistically significant (χ²=100.1, P=0.001). Multivariate Logistic regression analysis indicated that age was a high-risk factor for type 2 diabetic periodontitis (P=0.001, OR=2.13, 95%CI 1.79?2.55). Compared with younger patients with diabetes mellitus, elderly patients with diabetes mellitus were more likely to have periodontal symptoms such as gingival bleeding (χ²=36.4, P=0.001), tooth loosening (χ²=25.9, P=0.002) and masticatory weakness (χ²=12.3, P=0.006). There were significant differences in PLI (χ²=8.3, P=0.041), CI (χ²=12.8, P=0.005) and CAL (χ²=32.5, P=0.001) among diabetic patients of different ages. There were significant differences in periodontal health care measures, such as brushing teeth (χ²=18.8, P=0.001), rinsing mouth with water (χ²=21.8, P=0.001) and frequency of tooth brushing (χ²=24.0, P=0.001).

Conclusion

·The age of diabetic patients is a risk factor affecting the prevalence rate and severity of periodontitis. It is necessary to pay attention to the periodontal health of elderly diabetic patients and carry out targeted oral health care.

Key words: type 2 diabetes mellitus, chronic periodontitis, age, risk factor, oral health

CLC Number:

R780.1

Yuan-sen DING, Feng WANG, Jia-yue SUN, Zheng-wei SHAO, De-rong ZOU, Jia-yu LU. Epidemiological survey of periodontal health in patients with type 2 diabetes mellitus of different ages[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021,(2): 217-222.

Figures/Tables 5

TrendMD

References 19

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Group	Periodontal patients (n=670)	Non-periodontal patients (n=246)	χ²	Pvalue
Age/n (%)			100.1	0.001
<45 year	23 (3.4)	44 (17.9)
45?59 year	163 (24.3)	102 (41.5)
60?74 year	399 (59.6)	89 (36.2)
≥75 year	85 (12.7)	11 (4.5)
Gender/n (%)			0.4	0.529
Male	312 (46.6)	121 (49.2)
Female	358 (53.4)	125 (50.8)
Drug therapy/n (%)			6.3	0.012
Yes	614 (91.6)	211 (85.8)
No	56 (8.4)	35 (14.2)
Diet control/n (%)			1.4	0.238
Yes	554 (82.7)	205 (83.3)
No	116 (17.3)	41 (16.7)
Physical exercise/n (%)			1.6	0.203
Yes	543 (81.0)	209 (85.0)
No	127 (19.0)	37 (15.0)
Smoking History/n (%)			1.3	0.517
Yes	92 (13.7)	28 (11.4)
No	530 (79.1)	203 (82.5)
Smoking cessation	48 (7.2)	15 (6.1)
Alcoholic History/n (%)			3.0	0.220
Yes	116 (17.3)	52 (21.1)
No	540 (80.6)	186 (75.6)
Abstinence	14 (2.1)	8 (3.3)
Diabetic complications/n (%)			5.2	0.022
Yes	117 (17.5)	27 (11.0)
No	553 (82.5)	219 (89.0)
Diabetes duration/n (%)			15.4	0.004
<5 year	203 (30.3)	106 (43.1)
5?10 year	183 (27.3)	62 (25.2)
11?15 year	115 (17.2)	36 (14.6)
16?20 year	77 (11.5)	22 (8.9)
>20 year	92 (13.7)	20 (8.1)
FBG/n (%)			1.9	0.391
<7.0 mmoL·L^-1	138 (20.6)	61 (24.8)
7.0?11.1 mmoL·L^-1	442 (66.0)	153 (62.2)
>11.1 mmoL·L^-1	90 (13.4)	32 (13.0)

Group	Periodontal patients (n=670)	Non-periodontal patients (n=246)	χ²	Pvalue
Age/n (%)			100.1	0.001
<45 year	23 (3.4)	44 (17.9)
45?59 year	163 (24.3)	102 (41.5)
60?74 year	399 (59.6)	89 (36.2)
≥75 year	85 (12.7)	11 (4.5)
Gender/n (%)			0.4	0.529
Male	312 (46.6)	121 (49.2)
Female	358 (53.4)	125 (50.8)
Drug therapy/n (%)			6.3	0.012
Yes	614 (91.6)	211 (85.8)
No	56 (8.4)	35 (14.2)
Diet control/n (%)			1.4	0.238
Yes	554 (82.7)	205 (83.3)
No	116 (17.3)	41 (16.7)
Physical exercise/n (%)			1.6	0.203
Yes	543 (81.0)	209 (85.0)
No	127 (19.0)	37 (15.0)
Smoking History/n (%)			1.3	0.517
Yes	92 (13.7)	28 (11.4)
No	530 (79.1)	203 (82.5)
Smoking cessation	48 (7.2)	15 (6.1)
Alcoholic History/n (%)			3.0	0.220
Yes	116 (17.3)	52 (21.1)
No	540 (80.6)	186 (75.6)
Abstinence	14 (2.1)	8 (3.3)
Diabetic complications/n (%)			5.2	0.022
Yes	117 (17.5)	27 (11.0)
No	553 (82.5)	219 (89.0)
Diabetes duration/n (%)			15.4	0.004
<5 year	203 (30.3)	106 (43.1)
5?10 year	183 (27.3)	62 (25.2)
11?15 year	115 (17.2)	36 (14.6)
16?20 year	77 (11.5)	22 (8.9)
>20 year	92 (13.7)	20 (8.1)
FBG/n (%)			1.9	0.391
<7.0 mmoL·L^-1	138 (20.6)	61 (24.8)
7.0?11.1 mmoL·L^-1	442 (66.0)	153 (62.2)
>11.1 mmoL·L^-1	90 (13.4)	32 (13.0)

Variate	β value	SE	Wald χ²	P value
Age	0.07	0.019	9.12	0.001
Drug therapy	0.34	0.250	1.36	0.170
Diabetic complications	0.40	0.240	1.65	0.100
Diabetes duration	0.01	0.070	0.22	0.840
Glycemic control	0.15	0.080	1.77	0.080

Variate	β value	SE	Wald χ²	P value
Age	0.07	0.019	9.12	0.001
Drug therapy	0.34	0.250	1.36	0.170
Diabetic complications	0.40	0.240	1.65	0.100
Diabetes duration	0.01	0.070	0.22	0.840
Glycemic control	0.15	0.080	1.77	0.080

Age	N	Missing teeth/n	Gingival bleeding/n (%)	Gingival swelling/n (%)	Tooth loosening/n (%)	Automatic tooth loss/n (%)	Masticatory weakness/n (%)
<45 year	67	0 (0, 1)	31 (46.3)	24 (35.8)	10 (14.9)	5 (7.5)	9 (13.4)
45?59 year	265	1 (0, 3)	149 (57.1)	73 (28.0)	108 (41.4)	28 (10.7)	78 (29.9)
60?74 year	488	3 (1, 7)	348 (70.9)	149 (30.3)	219 (44.6)	69 (14.1)	151 (30.8)
≥75 year	96	6 (3, 15)	76 (78.4)	22 (22.7)	50 (51.5)	12 (12.4)	37 (38.1)
χ²	?	196.6	36.4	4.0	25.9	3.7	12.3
P value	?	0.001	0.001	0.260	0.002	0.300	0.006