Effectiveness of Oral Hygiene Instruction (OHI) in Improving Periodontal Disease among Subjects with Diabetes Mellitus (DM): A Randomized Controlled Trial

Abstractackground While dental scaling and root planing is effective in treating early periodontal disease (PD), little is known about the additional benefit of appliying oral hygiene instruction (OHI) in patients with PD, particularly co-existing with impaired fasting glucose (IFG) or diabetes mellitus (DM). im A randomized controlled trial was conducted to assess the efficacy of OHI in treating PD in subjects with hyperglycemia.ethod The population is targeted at Keelung residents aged 35-54 years with fasting plasma glucose (FPG) greater than 110mg/dL or DM history from the participants enrolled in the Keelung Community-based Integrated Screening (KCIS) program between 2006 and 2007. A total 138 subjects with baseline CPI equal to 2 or 3 were randomly assigned to two arms, 69 subjects in the study group with core treatment together with OHI and the other 69 subjects in the control group with core treatment only. OHI consist of how to apply disclosing agent and the illustration of dental plaque, Bass tooth brushing method, and the procedure of dental floss. The primary outcomes consist of Community Periodontal Index (CPI) and Bleeding on Probing (BOP). After intervention, each participant was followed at one month and three months to keep record of CPI and BOP. Wilcoxon rank sum test was first adopted to assess the difference of CPI and BOP in the two groups. The multiple linear mixed model was further applied to assess the difference of CPI and BOP between the study group and the control group at both one-month and three-month follow-up times.esults No statistically significant differences in baseline characteristics and CPI or BOP were found between the study group and the control group. There were lacking of statistically significant difference in CPI or BOP at both one-month and three-month follow-up with consideration of independence assumption. By using a linear mixed models that take correlation with compound symmetry into account, the study group yielded lower CPI than the control group, but the difference of CPI was not statistically significant (difference=-0.04881, p-value=0.6869) at one-month follow-up. Nor was that of BOP (difference=-0.2075, p-value=0.1917) with respect to CPI or BOP. No significant difference was also found at three-month follow-up.onclusion The OHI is not effective in ameliorating PD while it was combined with dental scaling and root planing.ey word: Bleeding on Probing (BOP), Community-based, Community Periodontal Index (CPI), Diabetes, Peridontal Disease, Oral Hygiene Instruction (OHI), Randomized Control Trial (RCT).