Periodontal Disease among Children and Adolescents with Type 2 Diabetes-Mellitus

Objective: To determine the periodontal status of a group of type 2 diabetes mellitus (T2DM) children and adolescents, managed by The Texas Children's Hospital in Houston, Texas. Methods: Test subjects consisted of a group of children and adolescents diagnosed with T2DM. Siblings served as controls. This was a cross-sectional study. Periodontal parameters obtained by a single and standardized operator were: plaque index, gingival index, probing depth (PD), clinical attachment loss (CAL), and bleeding on probing (BOP). Posterior bitewing radiographs were taken to determine alveolar bone loss. Medical and dental histories and HbA1c values were obtained on the day of examination. Results: A total of 55 subjects (T2DM = 32) with ages ranging between 8 and 19 years (mean 14.2 years) participated in this study. A significant difference was seen between tests and controls in both PD and CAL. The mean PD in the T2DM group was 2.28mm compared to 2.10mm in the non-diabetic group. The mean CAL in the T2DM group was 0.18mm compared to 0.01mm in the non-diabetic group (p=0.012). A significantly higher percentage of sites with BOP were seen in T2DM subjects with poorer glycemic control (47.6% vs. 22.3%; p=0.027). A significant correlation was also seen between duration of diabetes and BOP (p=0.018; r = 0.524). Conclusions: Although the clinical differences were small, diabetic subjects had significantly greater CAL and PD than the non-DM controls. Poor glycemic control and increasing duration of diabetes had a significant negative effect on gingival health.

This study was funded in part by PHS NIH NCRR General Clinical Research Center, Grant # M01RR002558.