Type 1 Diabetes Mellitus Patients' Self-perception of Periodontal Diseases

Zaridah Zainal Abidin; Erni Noor; Noor Shafina Mohd Nor; Nor Shafina Mohamed Nazari; Azriyanti Anuar Zaini; Nurul Zeety Azizi; Shahrul Aiman Soelar; Marshah Mohamad Shahrizad; Rohaida Abdul Halim

doi:10.1055/s-0043-1772777

European Journal of Dentistry, Table of Contents

CC BY 4.0 · Eur J Dent 2024; 18(02): 534-543
DOI: 10.1055/s-0043-1772777

Original Article

Type 1 Diabetes Mellitus Patients' Self-perception of Periodontal Diseases

Zaridah Zainal Abidin

¹Centre of Paediatric Dentistry and Orthodontics Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia

,

Erni Noor

²Centre of Studies for Periodontology, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia

,

Noor Shafina Mohd Nor

³Department of Paediatrics, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia

⁴Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia

,

Nor Shafina Mohamed Nazari

⁵Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia

,

Azriyanti Anuar Zaini

⁶Paediatric Department, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

,

Nurul Zeety Azizi

⁷Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia

,

Shahrul Aiman Soelar

⁸Clinical Research Centre, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia

,

Marshah Mohamad Shahrizad

⁹Kuching Division Dental Office, Sarawak State Dental Health Department, Braang Bayur Dental Clinic, Sarawak, Malaysia

,

Rohaida Abdul Halim

¹Centre of Paediatric Dentistry and Orthodontics Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia

› Author Affiliations

Abstract

Objectives The study aimed to evaluate type 1 diabetes mellitus (T1DM) patients' self-perceived periodontal health status and to identify the association between periodontal disease (PD) and DM.

Materials and Methods This cross-sectional study included 113 T1DM children between 3 and 18 years old from the Universiti Teknologi MARA and the University of Malaya. Periodontal health parameters, including plaque index, gingival index, probing pocket depth, simplified basic periodontal examination, and clinical attachment loss, were recorded. Self-perceived periodontal health status was assessed with questionnaires.

Statistical Analysis Statistical analysis was performed to evaluate the sensitivity of the questionnaire and the relationship between T1DM and periodontal parameters.

Results The median age was 11.4 years. Half of them (50.4%) were females. A total of 83.5% rated their oral condition as good, whereas 27.5% reported a history of gingival bleeding. Clinical examination revealed that 48.7% had healthy gingiva, whereas 47.8% had gingivitis. The question “Do you have bleeding when brushing, flossing, or eating food?” showed good accuracy in the evaluation of PD (p < 0.001).

Conclusion The questionnaire has a high potential to be used by medical professionals in identifying T1DM patients at risk of PD to guide nondental health care providers in making appropriate referrals to dental services.

Keywords

periodontal disease - type 1 diabetes mellitus - diabetes mellitus - oral health - self-perception

Full Text

References

References
1 Mattson JS, Cerutis DR. Diabetes mellitus: a review of the literature and dental implications. Compend Contin Educ Dent 2001; 22 (09) 757-760 , 762, 764 passim, quiz 773
2 Liese AD, D'Agostino Jr RB, Hamman RF. et al; SEARCH for Diabetes in Youth Study Group. The burden of diabetes mellitus among US youth: prevalence estimates from the SEARCH for Diabetes in Youth Study. Pediatrics 2006; 118 (04) 1510-1518
3 Harding JL, Pavkov ME, Magliano DJ, Shaw JE, Gregg EW. Global trends in diabetes complications: a review of current evidence. Diabetologia 2019; 62 (01) 3-16
4 Chiang JL, Maahs DM, Garvey KC. et al. Type 1 diabetes in children and adolescents: a position statement by the American Diabetes Association. Diabetes Care 2018; 41 (09) 2026-2044
5 Irfan UM, Dawson DV, Bissada NF. Epidemiology of periodontal disease: a review and clinical perspectives. J Int Acad Periodontol 2001; 3 (01) 14-21
6 Kinane DF, Berglundh T, Lindhe J. Host-parasite interaction in periodontal disease. 4th ed.. Clinical Periodontology and Implant Dentistry. Blackwell Munksgaard; 2003
7 Papapanou PN. Periodontal diseases: epidemiology. Ann Periodontol 1996; 1 (01) 1-36
8 Nelson RG, Shlossman M, Budding LM. et al. Periodontal disease and NIDDM in Pima Indians. Diabetes Care 1990; 13 (08) 836-840
9 Thorstensson H, Hugoson A. Periodontal disease experience in adult long-duration insulin-dependent diabetics. J Clin Periodontol 1993; 20 (05) 352-358
10 Mealey BL, Ocampo GL. Diabetes mellitus and periodontal disease. Periodontol 2000 2007; 44: 127-153
11 Cianciola LJ, Park BH, Bruck E, Mosovich L, Genco RJ. Prevalence of periodontal disease in insulin-dependent diabetes mellitus (juvenile diabetes). J Am Dent Assoc 1982; 104 (05) 653-660
12 Lalla E, Cheng B, Lal S. et al. Diabetes mellitus promotes periodontal destruction in children. J Clin Periodontol 2007; 34 (04) 294-298
13 Preshaw PM, Bissett SM. Periodontitis and diabetes. Br Dent J 2019; 227 (07) 577-584
14 Casanova L, Hughes FJ, Preshaw PM. Diabetes and periodontal disease: a two-way relationship. Br Dent J 2014; 217 (08) 433-437
15 Liu R, Desta T, He H, Graves DT. Diabetes alters the response to bacteria by enhancing fibroblast apoptosis. Endocrinology 2004; 145 (06) 2997-3003
16 Liu R, Bal HS, Desta T, Behl Y, Graves DT. Tumor necrosis factor-alpha mediates diabetes-enhanced apoptosis of matrix-producing cells and impairs diabetic healing. Am J Pathol 2006; 168 (03) 757-764
17 Frantzis TG, Reeve CM, Brown Jr AL. The ultrastructure of capillary basement membranes in the attached gingiva of diabetic and nondiabetic patients with periodontal disease. J Periodontol 1971; 42 (07) 406-411
18 Listgarten MA, Ricker Jr FH, Laster L, Shapiro J, Cohen DW. Vascular basement lamina thickness in the normal and inflamed gingiva of diabetics and non-diabetics. J Periodontol 1974; 45 (09) 676-684
19 Mandell RL, Dirienzo J, Kent R, Joshipura K, Haber J. Microbiology of healthy and diseased periodontal sites in poorly controlled insulin dependent diabetics. J Periodontol 1992; 63 (04) 274-279
20 Mashimo PA, Yamamoto Y, Slots J, Park BH, Genco RJ. The periodontal microflora of juvenile diabetics. Culture, immunofluorescence, and serum antibody studies. J Periodontol 1983; 54 (07) 420-430
21 Ukai T, Ichikawa S, Sekimoto M, Shikata S, Takemura Y. Effectiveness of monthly and bimonthly follow-up of patients with well-controlled type 2 diabetes: a propensity score matched cohort study. BMC Endocr Disord 2019; 19 (01) 43
22 Fisher E, Lazar L, Shalitin S. et al. Association between glycemic control and clinic attendance in emerging adults with type 1 diabetes: a tertiary center experience. J Diabetes Res 2018; 2018: 9572817
23 Smith A, Harris C. Type 1 diabetes: management strategies. Am Fam Physician 2018; 98 (03) 154-162
24 Babatzia A, Papaioannou W, Stavropoulou A. et al. Clinical and microbial oral health status in children and adolescents with type 1 diabetes mellitus. Int Dent J 2020; 70 (02) 136-144
25 Siddiqi A, Zafar S. The two-way link between diabetes mellitus and periodontal disease: medical-healthcare professionals' clinical practice. Biomed J Sci Tech Res 2022; 44: 32793
26 Moore J, Csikar J, Kang J, Tugnait A, Campbell F, Clerehugh V. Awareness, practices, training, and confidence of paediatric diabetes care teams in relation to periodontitis. Pediatr Diabetes 2020; 21 (02) 384-389
27 Matrooshi KA, Raeesi SA, Tawfik AR. et al. Knowledge of physicians about the interrelationship between diabetes mellitus and periodontitis in the United Arab Emirates. Eur J Dent 2023; 17 (01) 219-226
28 Borgnakke WS. IDF diabetes atlas: diabetes and oral health - a two-way relationship of clinical importance. Diabetes Res Clin Pract 2019; 157: 107839
29 Myers-Wright N, Cheng B, Tafreshi SN, Lamster IB. A simple self-report health assessment questionnaire to identify oral diseases. Int Dent J 2018; 68 (06) 428-432
30 Mohd-Said S, Mohd-Norwir NA, Ariffin AN. et al. Validation of a simplified digital periodontal health screening module for general dental practitioners. Healthcare (Basel) 2022; 10 (10) 1916
31 Montero E, La Rosa M, Montanya E. et al. Validation of self-reported measures of periodontitis in a Spanish population. J Periodontal Res 2020; 55 (03) 400-409
32 Perdoncini NN, Furquim CP, Bonfim CMS, Soares GMS, Torres-Pereira CC. Self-perception of periodontal health status among individuals with Fanconi anemia. Hematol Transfus Cell Ther 2021; 43 (04) 453-458
33 Abbood HM, Hinz J, Cherukara G, Macfarlane TV. Validity of self-reported periodontal disease: a systematic review and meta-analysis. J Periodontol 2016; 87 (12) 1474-1483
34 Fuziah MZ, Hong JY, Zanariah H. et al. A national database on children and adolescent with diabetes (e-DiCARE): results from April 2006 to June 2007. Med J Malaysia 2008; 63 (Suppl C): 37-40
35 O'Neil KJ, Jonnalagadda SS, Hopkins BL, Kicklighter JR. Quality of life and diabetes knowledge of young persons with type 1 diabetes: influence of treatment modalities and demographics. J Am Diet Assoc 2005; 105 (01) 85-91
36 CDC. Individual growth charts. Accessed May 5, 2022 at: http://www.cdc.gov/growthcharts/charts.htm
37 Blood pressure levels for boys and girls by age and height percentile. Accessed May 5, 2022, at: https://www.nhlbi.nih.gov/files/docs/guidelines/child_tbl.pdf
38 Flynn JT, Kaelber DC, Baker-Smith CM. et al; Subcommittee on screening and management of high blood pressure in children. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 2017; 140 (03) e20171904
39 Kim G, DeSalvo D, Guffey D. et al. Dyslipidemia in adolescents and young adults with type 1 and type 2 diabetes: a retrospective analysis. Int J Pediatr Endocrinol 2020; 2020: 11
40 Janet M. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics 2011; 128 (Suppl 5, Suppl 5): S213-S256
41 DiMeglio LA, Acerini CL, Codner E. et al. ISPAD Clinical Practice Consensus Guidelines 2018: glycemic control targets and glucose monitoring for children, adolescents, and young adults with diabetes. Pediatr Diabetes 2018; 19 (Suppl. 27) 105-114
42 Han TM, Ismail R, Yaacob M. et al. Validation of self-reported questionnaires to screen periodontal disease among diabetes patients: a study at selected health centers in Kuantan. Malays Fam Physician 2016; 11 (01) 9
43 Han TM. Effectiveness of medical-dental coordinated care for diabetes patients with periodontal disease at selected public primary care clinic in Kuantan, Pahang [Doctoral Dissertation]. 2018
44 Clerehugh V, Kindelan S. Guideline for periodontal screening and management of children and adolescent under 18 years of age. British Society of Periodontology and The British Society of Paediatric Dentistry. 2021
45 Rapp GE, Garcia RV, Motta AC, Andrade IT, Bião MA, Carvalho PB. Prevalence assessment of periodontal disease in 3-6 year old children through PSR–a pilot study. J Int Acad Periodontol 2001; 3 (03) 75-80
46 Silness J, Loe H. Periodontal disease in pregnancy. Ii. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 1964; 22: 121-135
47 Loe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 1963; 21: 533-551
48 Löe H. Periodontal disease. The sixth complication of diabetes mellitus. Diabetes Care 1993; 16 (01) 329-334
49 Mealey BL. Periodontal disease and diabetes. A two-way street. J Am Dent Assoc 2006; 137 (Suppl): 26S-31S
50 Zainal Abidin Z, Zainuren ZA, Noor E, Mohd Nor NS, Mohd Saffian S, Abdul Halim R. Periodontal health status of children and adolescents with diabetes mellitus: a systematic review and meta-analysis. Aust Dent J 2021; 66 (Suppl. 01) S15-S26
51 Iwasaki M, Usui M, Ariyoshi W. et al. Validation of a self-report questionnaire for periodontitis in a Japanese population. Sci Rep 2021; 11 (01) 15078
52 Kallio P, Nordblad A, Croucher R, Ainamo J. Self-reported gingivitis and bleeding gums among adolescents in Helsinki. Community Dent Oral Epidemiol 1994; 22 (5 Pt 1): 277-282
53 Goulão B, MacLennan GS, Ramsay CR. Have you had bleeding from your gums? Self-report to identify gingival inflammation (The SING diagnostic accuracy and diagnostic model development study). J Clin Periodontol 2021; 48 (07) 919-928
54 Nadanovsky P, Dos Santos APP, Bloch KV. Prevalence of self-reported gingival bleeding in a representative sample of the Brazilian adolescent population. J Clin Periodontol 2018; 45 (08) 952-958
55 Elhassan A, Alfakry H, Peeran S. Reasons to seek periodontal treatment in a Libyan community. Dent Med Res 2017; 5 (02) 38-42
56 Nelson DE, Holtzman D, Bolen J, Stanwyck CA, Mack KA. Reliability and validity of measures from the Behavioral Risk Factor Surveillance System (BRFSS). Soz Praventivmed 2001; 46 (Suppl. 01) S3-S42
57 Reiniger APP, Londero AB, Ferreira TGM, da Rocha JM, Moreira CHC, Kantorski KZ. Validity of self-reported measures for periodontitis surveillance in a rural sample. J Periodontol 2020; 91 (05) 617-627
58 Al-Batayneh OB, Al-Khateeb HO, Ibrahim WM, Khader YS. Parental knowledge and acceptance of different treatment options for primary teeth provided by dental practitioners. Front Public Health 2019; 7: 322
59 Hamasha A, Rasheed S, Aldosari M, Rajion Z. Parents knowledge and awareness of their children's oral health in Riyadh, Saudi Arabia. Open Dent J 2019; 13: 236-241
60 Butani Y, Gansky SA, Weintraub JA. Parental perception of oral health status of children in mainstream and special education classrooms. Spec Care Dentist 2009; 29 (04) 156-162
61 Daly JM, Levy SM, Xu Y. et al. Changes in parental perceptions of their care of their children's oral health from age 1 to 4 years. J Prim Care Community Health 2019; 10: 2150132719836908
62 Gomes MC, Clementino MA, Pinto-Sarmento TC. et al. Parental perceptions of oral health status in preschool children and associated factors. Braz Dent J 2015; 26 (04) 428-434
63 Cyrino RM, Miranda Cota LO, Pereira Lages EJ, Bastos Lages EM, Costa FO. Evaluation of self-reported measures for prediction of periodontitis in a sample of Brazilians. J Periodontol 2011; 82 (12) 1693-1704
64 Vered Y, Sgan-Cohen HD. Self-perceived and clinically diagnosed dental and periodontal health status among young adults and their implications for epidemiological surveys. BMC Oral Health 2003; 3 (01) 3
65 Romano F, Perotto S, Bianco L, Parducci F, Mariani GM, Aimetti M. Self-perception of periodontal health and associated factors: a cross-sectional population-based study. Int J Environ Res Public Health 2020; 17 (08) 2758
66 Sanz M, Tonetti MS. New classification of periodontal and peri implant disease. . Eur Federation Periodontol 2019. Accessed May 5, 2022 at: https://www.efp.org/fileadmin/uploads/efp/Documents/Campaigns/New_Classification/Guidance_Notes/report-02.pdf
67 Nguyen VTN, Furuta M, Zaitsu T. et al. Periodontal health predicts self-rated general health: a time-lagged cohort study. Community Dent Oral Epidemiol 2022; 50 (05) 421-429
68 Chatzopoulos GS, Tsalikis L, Konstantinidis A, Kotsakis GA. A two-domain self-report measure of periodontal disease has good accuracy for periodontitis screening in dental school outpatients. J Periodontol 2016; 87 (10) 1165-1173
69 Lipski J, Burchardt D, Duda-Sobczak A, Wyganowska M. The assessment of the relationship between the severity of gingivitis and the glycosylated hemoglobin levels in adolescent and adult patients with type 1 diabetes. Postepy Hig Med Dosw 2021; 75: 868-872
70 Mobasseri M, Shirmohammadi M, Amiri T, Vahed N, Hosseini Fard H, Ghojazadeh M. Prevalence and incidence of type 1 diabetes in the world: a systematic review and meta-analysis. Health Promot Perspect 2020; 10 (02) 98-115