Relationship between glycemic control and periodontal status in patients with type 1 diabetes mellitus

Relevance. The study of the dental status, including periodontal, in adolescents with type 1 diabetes, has a high scientific and clinical significance in terms of early diagnosis and prediction of the pathology of the dentoalveolar system in this group of patients.

Materials and methods. The study included 54 adolescents with type 1 diabetes aged 14-17 y.o.; of which 44% were boys, and 56% were girls. The duration of diabetes was 71.2 ± 46 months. Oral cavity condition evaluation included an interview and examination using instrumental and index assessment. The index assessment included the Green-Vermilion oral hygiene index (OHI-S), the papillary-marginal-attached index (PMA), Russell’s periodontal index (PI) and the decayed-missing-filled index (DMFT). To evaluate the diabetes factor impact on the periodontal tissues, we assessed the level of HbA1c, the duration of DM1, sex, age, and the presence of microangiopathy specific for type 1 diabetes, followed by multivariate regression analysis using JAMOVI 2.3.13 software.

Results. The study established that only 11% of the examined adolescents had compensated type 1 diabetes with an HbA1c level <7%. As for the index assessment of the oral cavity condition, most patients had mild or moderate deviations, indicating initial changes, including ones in periodontium. We also established a significant adverse effect of HbA1c increase, i.e., metabolic decompensation, on all studied indices (OHI-S, PI, PMA).

Conclusion. Initial inflammatory periodontal changes in type 1 DM may occur at a fairly early age and do not depend on age, sex and the presence of vascular complications, and are associated with worse glycemic control numbers. Dental check-ups of adolescents with type 1 diabetes require periodontal index assessment and collaboration of dentists and pediatric endocrinologists.

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