Oral health in patients with diabetes - a component of comprehensive medical assessment
DOI:
https://doi.org/10.52556/2587-3873.2024.5(102).10Keywords:
diabetes mellitus, oral health, periodontal diseasesAbstract
Periodontal disease and diabetes mellitus are complex pathologies with an increased prevalence in the general population. Poorly controlled diabetes mellitus is associated with an increased prevalence and severity of periodontitis, and severe periodontitis is associated with compromised glycemic control. A search was performed for articles published in English in the PubMed database between January 2000 and March 2024 that aimed to investigate the interrelationship between diabetes and periodontal disease. Diabetes mellitus and periodontal disease are a public health problem, driven by their increased prevalence and chronic complications affecting quality of life. Periodontitis, changes in salivary flow, and fungal infections are just a number of pathologies with a higher prevalence in people with type 2 diabetes mellitus. The interrelationship between periodontitis and diabetes mellitus has been shown to be bidirectional, so that periodontitis hinders the achieve Periodontal disease and diabetes mellitus are complex pathologies with an increased prevalence in the general population. Poorly controlled diabetes mellitus is associated with an increased prevalence and severity of periodontitis, and severe periodontitis is associated with compromised glycemic control. A search was performed for articles published in English in the PubMed database between January 2000 and March 2024 that aimed to investigate the interrelationship between diabetes and periodontal disease. Diabetes mellitus and periodontal disease are a public health problem, driven by their increased prevalence and chronic complications affecting quality of life. Periodontitis, changes in salivary flow, and fungal infections are just a number of pathologies with a higher prevalence in people with type 2 diabetes mellitus. The interrelationship between periodontitis and diabetes mellitus has been shown to be bidirectional, so that periodontitis hinders the achievement of therapeutic goals and its presence may increase the risk of developing diabetes, while diabetes mellitus may also contribute to the development of periodontitis. However, the knowledge of medical practitioners about the importance of oral health in people with diabetes, as well as the knowledge of dentists about the importance of diabetes for oral health, is limited. The multidisciplinary approach to a person with type 2 diabetes mellitus requires the formation of interdisciplinary teams, in which the dentist should certainly be included.
References
1. AEMAIMANAN, P., AMIMANAN, P., TAWEECHAISUPAPONG, S. Quantification of key periodontal pathogens in insulin-dependent type 2 diabetic and non-diabetic patients with generalized chronic periodontitis. In: Anaerobe. 2013; nr.22, pp.64-68. ISSN: 1075-9964. https://doi.org/10.1016/j.anaerobe.2013.06.010
2. American Diabetes Association Professional Practice Committee; 4th Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes-2024. In: Diabetes Care 2024; nr.47 (Supplement_1): pp.52-76. ISSN: 0149-5992.
3. BATTANCS, E., GHEORGHITA, D., NYIRATY, S., et al. Periodontal disease in diabet mellitus: A case-control study in smokers and non-smokers. In: Diabetes Therapy. 2020; nr.11, pp.2715-2728. ISSN: 1869-6961. https://doi.org/10.1007/s13300-020-00933-8
4. BORGNAKKE, W.S., YLÖSTALO, P.V., TAYLOR, G.W., GENCO, R.J. Effect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence. In: Journal Periodontology. 2013 nr.84 (4 Suppl): pp.135-52. ISSN: 0022-3492. https://doi.org/10.1902/jop.2013.1340013
5. CASANOVA, L., HUGHES, F.J., PRESHAW, P.M. Diabetes and periodontal disease: a two-way relationship. In: British Dental Journal. 2014 nr.217(8), pp.433-437. ISSN: 1476-5373. https://doi.org/10.1038/sj.bdj.2014.907
6. CASARIN, R., BARBAGALLO, A., MEULMAN, T., et al. Subgingival biodiversity in subjects with uncontrolled type-2 diabetes and chronic periodontitis. In: Journal of Periodontal Research. 2013; nr.48, pp.30-36. ISSN: 1600-0765. https://doi.org/10.1111/j.1600-0765.2012.01498.x
7. CATON, J., G., ARMITAGE, G., BERGLUNDH, T., et al. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. In: Journal of Clinical Periodontology. 2018, nr.89, pp.S1-S8. ISSN: 0303-6979. https://doi.org/10.1111/jcpe.12935
8. CHAVARRY, N.G., VETTORE, M.V., SANSONE, C., SHEIHAM, A. The relationship between diabetes mellitus and destructive periodontal disease: a meta-analysis. In: Oral Health and Preventive Dentistry 2009; 7: pp.107-127. ISSN: 1757-9996.
9. D'AIUTO, F., GABLE, D., SYED, Z., ALLEN, Y., WANYONYI, K.L., et al. Evidence summary: The relationship between oral diseases and diabetes. In: British Dental Journal. 2017; 222:944-948. ISSN: 1476-5373. https://doi.org/10.1038/sj.bdj.2017.544
10. D'AIUTO, F., GKRANIAS, N., BHOWRUTH, D., et al. Systemic effects of periodontitis treatment in patients with type 2 diabetes: a 12 month, single-centre, investigator-masked, randomised trial. In: Lancet Diabetes & Endocrinology. 2018 Dec;6(12):954-965. ISSN: 2213-8595. https://doi.org/10.1016/S2213-8587(18)30038-X
11. DEMMER, R.T., JACOBS, D.R.JR., SINGH, R., et al. Periodontal bacteria and prediabetes prevalence in ORIGINS: The oral infections, glucose intolerance, and insulin resistance study. In: Journal of Dental Research. 2015 94:201s-211s. ISSN: 1544-0591. https://doi.org/10.1177/0022034515590369
12. DICEMBRINI, I., SERNI, L., MONAMI, M., et al. Type 1 diabetes and periodontitis: Prevalence and periodontal destruction - A systematic review. In: Acta Diabetologica. 2020; 57:1405-1412. ISSN: 0940-5429. https://doi.org/10.1007/s00592-020-01531-7
13. DIEDISHEIM, M., CARCARINO, E., VANDIEDONCK, C., et al. Regulation of inflammation in diabetes: From genetics to epigenomics evidence. In: Molecular Metabolism. 2020; 41:101041. ISSN: 2212-8778. https://doi.org/10.1016/j.molmet.2020.101041
14. DYE, B.A. Global periodontal disease epidemiology. In: Journal of Periodontology. 2000 2012; 58:10-25. ISSN: 1943-3670. https://doi.org/10.1111/j.1600-0757.2011.00413.x
15. EKE, P., THORNTON-EVANS G., WEI, L., et al. Periodontitis in US Adults: National Health and Nutrition Examination Survey 2009-2014. In: Journal of the American Dental Association. 2018 Jul;149(7):576-588.e6. ISSN: 0002-8177. https://doi.org/10.1016/j.adaj.2018.04.023
16. ENGEBRETSON, S., KOCHER, T. Evidence that periodontal treatment improves diabetes outcomes: A systematic review and meta-analysis. In: Journal of Clinical Periodontology. 2013; 40:S153-S163. ISSN: 0303-6979. https://doi.org/10.1111/jcpe.12084
17. ESTRICH, C.G., ARAUJO, M.W.B., LIPMAN, R.D. Prediabetes and diabetes screening in dental care settings: NHANES 2013 to 2016. In: JDR Clinical & Translational Research. 2019; 4:76-85. ISSN: 2380-0852. https://doi.org/10.1177/2380084418798818
18. GONZÁLEZ-MOLES, M.Á., RAMOS-GARCÍA, P. State of Evidence on Oral Health Problems in Diabetic Patients: A Critical Review of the Literature. In: Journal of Clinical Medicine. 2021, November 18; vol.10:5383. ISSN: 2158-2882. https://doi.org/10.3390/jcm10225383
19. GOTSMAN, I., LOTAN, C., SOSKOLNE, W.A., et al. Periodontal destruction is associated with coronary artery disease and periodontal infection with acute coronary syndrome. In: Journal of Periodontology. 2007; 78:849-858. ISSN: 1943-3670. https://doi.org/10.1902/jop.2007.060301
20. GRAZIANI, F., GENNAI, S., SOLINI, A., PETRINI, M.A. Systematic review and meta-analysis of epidemiologic observational evidence on the effect of periodontitis on diabetes An update of the EFP-AAP review. In: Journal of Clinical Periodontology. 2018; 45:167-187. ISSN: 0303-6979. https://doi.org/10.1111/jcpe.12837
21. International Diabetes Federation. IDF Diabetes Atlas 10th ed. Brussels, Belgium: International Diabetes Federation, 2021. https://diabetesatlas.org/atlas/tenth-edition/
22. JEFFCOAT, M.K., HAUTH, J.C., GEURS, N.C., et al. Periodontal disease and preterm birth: Results of a pilot intervention study. In: Journal of Periodontology. 2003; 74:1214-1218. ISSN: 1943-3670. https://doi.org/10.1902/jop.2003.74.8.1214
23. KHADER, Y.S, DAUOD, A.S., EL-QADERI, S.S., et al. Periodontal status of diabetics compared with nondiabetics: a meta-analysis. In: Journal Diabetes Complications. 2006 Jan-Feb; 20(1): pp.59-68. ISSN: 1056-8727. https://doi.org/10.1016/j.jdiacomp.2005.05.006
24. KINANE, D.F., STATHOPOULOU, P.G., PAPAPANOU, P.N. Periodontal diseases. In: Nature Reviews Disease Primers. 2017; 3:17038. ISSN: 2056-676X. https://doi.org/10.1038/nrdp.2017.38
25. LOE, H. Periodontal disease. The sixth complication of diabetes mellitus. In: Diabetes Care 1993; 16:329-334. ISSN: 0149-5992. https://doi.org/10.2337/diacare.16.1.329
26. NASCIMENTO, G.G., LEITE, F.R.M., VESTERGAARD, P., et al. Does diabetes increase the risk of periodontitis? A systematic review and meta-regression analysis of longitudinal prospective studies. In: Acta Diabetologica. 2018; 55:653-667. ISSN: 0940-5429. https://doi.org/10.1007/s00592-018-1120-4
27. MILLER, A., OUANOUNOU, A. Diagnosis, management, and dental considerations for the diabetic patient. In: Journal Canadian Dental Association. 2020; 86: k8. ISSN: 1488-2159.
28. PAPAPANOU, P.N., LINDHE, J. Epidemiology of periodontal diseases. In: Clinical Periodontology and Implant Dentistry. John Wiley Sons; Chichester, UK: 2015. pp.125-168.
29. POLAK, D., SANUI, T., NISHIMURA, F., SHAPIRA, L. Diabetes as a risk factor for periodontal disease-plausible mechanisms. In: Journal of Periodontology 2000. 2020; 83:46-58. ISSN: 1943-3670. https://doi.org/10.1111/prd.12298
30. PRESHAW, P.M., ALBA, A.L., HERRERA, D. ET AL. Periodontitis and diabetes: a two-way relationship. In: Diabetologia 2012; 55:21-31. ISSN: 1432-0428. https://doi.org/10.1007/s00125-011-2342-y
31. PRESHAW, P., BISSETT, S. Periodontitis and diabetes. In: British Dental Journal 227, 577-584 (2019). ISSN: 1476-5373. https://doi.org/10.1038/s41415-019-0794-5
32. SANZ, M., CERIELLO, A., BUYSSCHAERT, M., et al. Scientific evidence on the links between periodontal diseases and diabetes: Consensus report and guidelines of the joint workshop on periodontal diseases and diabetes by the International diabetes Federation and the European Federation of Periodontology. In: Diabetes Ressearch and Clinical Practice. 2018; 137:231-241. ISSN: 1872-8227. https://doi.org/10.1016/j.diabres.2017.12.001
33. SAREMI, A., NELSON, R.G., TULLOCH-REID, M., et al. Periodontal disease and mortality in type 2 diabetes. In: Diabetes Care. 2005; 28:27-32. ISSN: 0149-5992. https://doi.org/10.2337/diacare.28.1.27
34. SHARMA P., DIETRICH T., FERRO C.J., et al. Association between periodontitis and mortality in stages 3-5 chronic kidney disease: NHANES III and linked mortality study. In: Journal of Clinical Periodontology. 2016; 43:104-113. ISSN: 0303-6979. https://doi.org/10.1111/jcpe.12502
35. SHELSWELL, J. Does periodontal treatment have an impact on metabolic control and systemic inflammation in patients with type 2 diabetes?. In: Evidence-Based Dentistry. 22, 40-41 (2021). ISSN: 1476-5446. https://doi.org/10.1038/s41432-021-0156-4
36. SHULTIS, W.A., WEIL, E.J., LOOKER, H.C., et al. Effect of periodontitis on overt nephropathy and end-stage renal disease in type 2 diabetes. In: Diabetes Care. 2007; 30:306-311. ISSN: 0149-5992. https://doi.org/10.2337/dc06-1184
37. SIDDIQI, A., ZAFAR, S., SHARMA, A., QUARANTA, A. Diabetes mellitus and periodontal disease: The call for interprofessional education and interprofessional collaborative care - A systematic review of the literature. In: Journal of Interprofessional Care. 2020: 1-9. ISSN: 1469-9567. https://doi.org/10.1080/13561820.2020.1825354
38. SIMPSON, T.C., WELDON, J.C., WORTHINGTON, H.V., et al. Treatment of periodontal disease for glycaemic control in people with diabetes mellitus. In: Cochrane Database of Systematic Reviews. 2015 Nov 6;2015(11):CD004714. ISSN: 1469-493X.
39. SUN, Q., FENG, M., ZHANG, M., et al. Effects of periodontal treatment on glycemic control in type 2 diabetic patients: A meta-analysis of randomized controlled trials. In: Chinese Journal of Physiology. 2014; 57:305-314. ISSN: 03044920, 26660059. https://doi.org/10.4077/CJP.2014.BAC262
40. TAYLOR, J.J., PRESHAW, P.M., LALLA, E. A review of the evidence for pathogenic mechanisms that may link periodontitis and diabetes. In: Journal of Clinical Periodontology. 2013; 40:S113-S134. ISSN: 0303-6979. https://doi.org/10.1111/jcpe.12059
41. TONETTI, M.S., GREENWELL, H., KORNMAN, K.S. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. In: Journal of Periodontology. 2018; 89:S159-S172. ISSN: 1943-3670. https://doi.org/10.1002/JPER.18-0006
42. TORRUNGRUANG, K., et al. Mediation analysis of systemic inflammation on the association between periodontitis and glycaemic status. In: Journal of Clinical Periodontology. 2018; 45:548-556. ISSN: 0303-6979. https://doi.org/10.1111/jcpe.12884
43. TURNER, C. Diabetes mellitus and periodontal disease: the profession's choices. In: British Dental Journal. 233, 537-538 (2022). ISSN: 1476-5373. https://doi.org/10.1038/s41415-022-5029-5
44. VERHULST, M. J., LOOS, B. G., GERDES, V. E. & TEEUW, W. J. Evaluating all potential oral complications of diabetes mellitus. In: Frontiers in Endocrinology. 10, 56 (2019). ISSN: 1664-2392. https://doi.org/10.3389/fendo.2019.00056
45. VU, G.T., SHAKIB, S., KING, C. ET AL. Association between uncontrolled diabetes and periodontal disease in US adults: NHANES 2009-2014. In: Scientific Reports. 13, 16694 (2023). ISSN: 20-45-2322. https://doi.org/10.1038/s41598-023-43827-y
46. WANG, T.F., JEN, I.A., CHOU, C., LEI, Y.P. Effects of periodontal therapy on metabolic control in patients with type 2 diabetes mellitus and periodontal disease: A meta-analysis. In: Medicine. 2014; 93:e292. ISSN: 1536-5964. https://doi.org/10.1097/MD.0000000000000292
47. WINNING, L., PATTERSON, C.C., NEVILLE, C.E., et al. Periodontitis and incident type 2 diabetes: A prospective cohort study. In: Journal of Clinical Periodontology. 2017; 44:266-274. ISSN: 0303-6979. https://doi.org/10.1111/jcpe.12691
48. WU, C., YUAN, Y., LIU, H., et al. Epidemiologic relationship between periodontitis and type 2 diabetes mellitus. In: BMC Oral Health. 2020; 20:204. ISSN: 1472-6831. https://doi.org/10.1186/s12903-020-01180-w
49. ZHENG, M., WANG, C., ALI, A., et al. Prevalence of periodontitis in people clinically diagnosed with diabetes mellitus: A meta-analysis of epidemiologic studies. In: Acta Diabetologica. 2021; 58:1307-1327. ISSN: 0940-5429. https://doi.org/10.1007/s00592-021-01738-2
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