Elucidating the Effect of Type2 Diabetes on Periodontal Disease
Date Issued
2006
Date
2006
Author(s)
Wang, Ting-Ting
DOI
zh-TW
Abstract
Background: This study was carried out to demonstrate the prevalence and incidence rate of periodontal disease(PD) by community periodontal index (CPI) and attachment loss (LA) and investigated the associations between Type 2 diabetes mellitus and periodontal disease by controlling for possible confounding factors by using community-based survey in Keelung. We also estimated the mean sojourn time (MST) of periodontal disease (PD) by prevalence pool concept.
Methods: Study population was based on participants in routine KCIS program who were 35-44 years from 2003 to 2005. The CPI and LA were used as screening tool to assess the status of PD. The courses focused on periodontal examination, diagnosis and basic treatment were carried out before the activity of Keelung Community-based Integrated Screening (KCIS) every year. The bioassay and questionnaire information were simultaneously collected by KCIS. To assess the effect of Type 2 DM on PD, a prospective cohort free of PD was designed for the investigation of the effect of Type 2 DM on PD. The univariate and multiple logistic regressions were performed to identify significant factors responsible for occurrence of PD. We used cumulative density method to calculate cumulative risk for developing PD based on incidence rate. Poisson regression model was further used to identify significant factors responsible for occurrence of incident PD. We applied prevalence pool concept based on prevalent cases at first survey and incidence cases after following up the cohort free of PD. The natural history of periodontal disease was proposed by three-state model for progression from free of PD, PD, and severest or tooth loss.
Results: The total of eligible 8765 attendants participated this KCIS multiple screening. The overall rate of PD defined by taking the severest one of CPI greater than 3 in different sextants in individual level was 29%. Similar findings were also noted for PD defined by loss attachment (LA>=1). The overall prevalence rate of loss attachment was 35%. The prevalence rates of severe CPI of male and female were 35.7% and 25.9% respectively. The prevalence rate increased with advancing age. The prevalence rate of PD in type2 diabetes was higher than that in non-diabetes by 11.3%, with 11.4% for male and 9% for female. The prevalence rate of PD in subjects with betel quids chewing was statistically higher than that in subjects without betel quids chewing by 14.3%. Multivariate logistic regression including significant indicated age (OR=1.06(CI: 1.04-1.07)), gender (OR=1.33(CI: 1.17-1.51)), twice brush-teeth per day (OR=0.70(CI: 0.52-0.95)), betel quid chewing (OR=1.29(CI: 1.08-1.54)), cigarette Smoking (OR=1.23(CI: 1.07-1.40)), Waist (OR=1.23(CI: 1.05-1.43)), and Type 2 DM (OR=1.45(CI: 1.09-1.92)). The association between Type 2 DM and PD defined by LA was borderline significant. The overall incidence of PD and specific incidence by age, gender, presence of Type 2 DM, and betel quids chewing. The incidence rate (in month) in the overall group was 14.61 (12.75-16.75) per 1000. The incidence rate (per 1000) increased with age, with 13.97 (11.76-16.61) per 1000 for subjects aged 35-39 years and 15.81 (12.66-19.74) per 1000 for subjects aged 40-44 years. The risks for PD for the overall group were 16.08%, 29.58%, 40.90%, 50.40%, and 58.38% at 1, 2, 3, 4 and 5 year of follow-up. Those diagnosed as T2DM or with the habit of betel quids chewing had higher risk for developing PD than those without Type 2 DM or the habit of betel quids chewing. After adjusting for significant factors obtained from univariate analysis, only betel quids chewing (relative risk=2.13 (CI: 1.31-3.46)) was statistically associated with the development of PD. The effect of T2DM on occurrence of PD was not statistically significant after controlling for betel quids chewing. The application of prevalence pool equation yielded 28.46 months of MST in chronic state for PD patients without appropriate intervention. The risk for having PD and for tooth missing during one-year period was 15.16% and 4.53% respectively.
Conclusions: We demonstrated a positive association between early-detected T2DM and PD based on a large population-based and community-oriented program targeted at habitant aged 35-44 years. However, the effect of Type 2 DM on newly discovered PD didn’t show significant finding. Instead, incidence rate was higher for those with the habit of betel quids chewing. This suggests the influence of Type 2 DM may be predominated by the impact of betel quids chewing. The MST estimated in the current study suggests one-year as an appropriate inter-examination interval for PD.
Subjects
第二型糖尿病
牙周病
社區整合式篩檢
社區牙周病指數
附連指數
Type 2 Diabetes
Periodontal Disease
Community-based integrated screening
SDGs
Type
thesis
File(s)![Thumbnail Image]()
Loading...
Name
ntu-95-P93846001-1.pdf
Size
23.31 KB
Format
Adobe PDF
Checksum
(MD5):4536a2c8d4f1c757019237d08ccb113d