Periodontal Disease among Diabetics in Uganda

Background: It has been suggested that long lasting poorly controlled diabetes mellitus increases risk for periodontal disease. Information about the prevalence of periodontal disease among diabetics in Africa and Uganda is scanty. Aims: To describe the prevalence and clinical features of periodontal disease in diabetic adult Ugandans attending diabetic clinics at two major hospitals in the capital city. Methods: Three trained and calibrated dentists carried out clinical examination under field conditions, using the WHO periodontal probe on consenting patients. Periodontal parameters assessed at 4 sites per tooth included probing depth and gingival recession; attachment loss was calculated from probing depth and recession measurements. Blood samples for HbAc1 analysis were taken from randomly selected subjects. All subjects answered a questionnaire, designed to provide information about demographics, oral hygiene practices and history of diabetic complications. Results: A total of 350 subjects were included in this study aged 25-90 (mean 51.5) years. About 71% of the sample were females and 300 (85.7%) were known diabetics. Known duration of diabetes (KDD) ranged between 1-36 years, and 37.6% had known their status for 1-2 years. Of the 110 (36.6%) randomly selected subjects who submitted blood samples for HbAc1 analysis, 28.2% had poorly controlled diabetes (HbAc1 values 9.0-15.8%). Gingival recession, probing depth, and loss of attachment equal/more than 4 mm on one or more teeth were present in 40.3%, 23.1%, and 76.0% of the sample, respectively. Prevalence of severe periodontitis tended to be higher among diabetics than controls, although the differences were not statistically significant. However, severe periodontal disease was significantly more prevalent among patients with long standing diabetes (KDD greater than 7 years) than new patients (KDD less than 2 years). Conclusion: Longstanding diabetes mellitus appears to predispose to severe periodontal disease in this sample.