Association of Periodontal Disease Severity with Diabetic Complications

Objectives: Periodontal disease has been proposed to be the sixth complication of diabetes mellitus. The association between periodontal disease severity and diabetes complications and duration in patients with 1 diabetes mellitus (DM) was investigated in this comparative cross-sectional study. Methods: Twenty-nine patients with type 1 DM of <=5 years duration were compared with 43 patients with > 5 years duration of DM. Complete medical history and examination and assessments of retinopathy, neuropathy, and nephropathy were performed by DM specialists, followed by assessments of the plaque index (PI), pocket depth (PD), clinical attachment level (CAL), and the number of missing teeth by one examiner masked to the diabetic control of the patients. Chi-square and logistic regression were used in analysis of the data. Results: The number of missing teeth (4 vs. 0) and CAL (2.88 vs. 2.56 mm) were significantly higher in patients with longer DM duration (p< 0.05). For patients with >= 5 years DM duration, periodontal disease severity was also greater in patients with >= 1 DM complication as assessed by the number of missing teeth (17 vs. 0; p< 0.001) and CAL (4.74 vs. 2.81 mm; p< 0.01). Stepwise multiple regression analysis associated the presence of >= 1 DM complication and smoking history with severe attachment loss (CAL >= 7 mm; p< 0.001). Conclusion: Periodontal disease severity is associated with both DM duration and the presence of DM complications in this sample of type 1 DM patients.