Evaluation of the relationship between type 2 diabetes and periodontal disease.

The association between periodontal disease and diabetes mellitus has been explored by many researchers over the years. Periodontal signs and symptoms are now recognized as the 'sixth complication of diabetes'. The objective of the present study was to investigate the association between glycemic control of type 2 diabetes mellitus (type 2 DM) and severity of periodontal disease. A total of 126 Saudi female patients diagnosed with type 2 Diabetes were examined. Group I (better control with Hb A1 c less than 9%) included 74 patients, and Group II (poor control with Hb A1c more than 9%) included 52 subjects. The periodontal parameters recorded were plaque index, bleeding index, presence of calculus, pocket depth measurement and clinical attachment level. These parameters were evaluated in a randomized half mouth examination on four sites of each tooth (mesial, distal, buccal and lingual). The results of this study showed that the age, duration of diabetes, percentage of plaque index and bleeding index showed no significant difference between the two groups. In contrast, there was a significantly higher percentage of calculus, PD > or = 4 mm and loss of attachment level (3-4 mm) in the poorly controlled diabetic patients, as compared to the better-controlled group. The result obtained showed a significant association of the loss of attachment level (3-4 mm) with periodontal disease in poorly controlled diabetic patients, as compared to better-controlled patients. Poor-control diabetics (group II) exhibited an increased percentage of calculus and greater risk for periodontitis.

Prevalence and distribution of dentin hypersensitivity and plaque in a dental hospital population.

OBJECTIVE: Dentin hypersensitivity (DH) is a commonly reported dental problem. Conflicting results on the degree of plaque accumulation at sites with DH have been reported. Therefore, the prevalence and distribution of DH and dental plaque were studied in a dental hospital population. METHOD AND MATERIALS: A total of 302 adult patients were examined for the presence of DH by means of a questionnaire and intraoral examinations. Oral hygiene was measured by Silness and Löe's Plaque Index. RESULTS: The overall prevalence of DH was 52.6%. Significantly more women complained of DH than men. Dentin hypersensitivity and Plaque Index scores were found to be significantly higher in the older age group than in younger groups. Spearman's correlation test revealed no correlation for DH with plaque. About half of the patients reported DH for a duration of within 1 month, while 23% claimed that their DH lasted for 1 to 5 years. Approximately 64% of the patients reported that sensitivity did not interfere with their ability to eat, drink, or brush their teeth, with slight to moderate discomfort, while 11.4% had a severe concern, thereby avoiding these activities most of the time. Of the patients, 17% received professional treatment, while 25% used desensitizing toothpastes. Dentin hypersensitivity was found in all types of teeth, but was most common in first molars and mandibular incisors and canines. CONCLUSION: Because there was no correlation for DH with plaque, a careful assessment of the etiologic or predisposing factors must be considered before attempting the management of patients complaining of hypersensitive teeth.

Type 2 diabetes mellitus, impaired glucose tolerance and associated factors in a rural Palestinian village.

AIMS: To investigate the prevalence of Type 2 diabetes mellitus and impaired glucose tolerance (IGT) and to identify risk factors associated with diabetes in a rural Palestinian village. METHODS: A cross-sectional, population-based study investigating 500 adults aged 30-65 years (response rate 85%) determined the diabetes status using the oral glucose tolerance test (OGTT). A standard questionnaire, a simple clinical examination and laboratory tests assessed blood lipids, blood pressure, waist-to-hip ratio (WHR), body mass index (BMI) and other risk factors for diabetes RESULTS: The prevalence of Type 2 diabetes was 9.8% (95% confidence interval 7.3-12.3) and IGT 8.6% (6.1-11.1), while the prevalence standardized to the European population was 11.6% (8.8-14.4) for Type 2 diabetes and 10.3% (7.6-13.0) for IGT. Age, positive family history, high triglycerides level, and high WHR were significantly associated with Type 2 diabetes. CONCLUSIONS: Of the factors associated with diabetes, WHR and triglycerides levels are potentially modifiable, and should be addressed by preventive health activities. The high prevalence of Type 2 diabetes mellitus and its potential increase as a result of the ageing of the Palestinian population constitutes a major public health problem.

The utility of a single glucometer measurement of fasting capillary blood glucose in the prevalence determination of diabetes mellitus in an urban adult Palestinian population.

This paper aims to evaluate the utility of a single glucometer fasting capillary blood glucose (FCBG) measurement in determining the prevalence of diabetes mellitus in a homogeneous adult population. FCBG measurements were compared with results of the oral glucose tolerance test (OGTT) in 445 subjects aged 30-65 years in an urban cross-sectional study in Old Ramallah. Prevalence of diabetes, sensitivity, specificity and predictive values were calculated at different cut-off levels of FCBG, using OGTT as the reference. The prevalence of OGTT-diagnosed diabetes was 2.7%, while it varied considerably using different cut-off levels of FCBG. The sensitivity of a single glucometer (Exac Tech II) measurement of FCBG at the cut-off level of 6.7 mmol 1(-1) was 33.3%, with a specificity of 98.8%. Using the cut-off level of 6.1 mmol 1(-1) as suggested by the 1998 provisional report of a WHO consultation, the sensitivity increased to 41.7%. At a cut-off level of 5.6 mmol 1(-1), a sensitivity of 66.6% was reached, but the specificity decreased slightly. It can be concluded that a single glucometer measurement of FCBG in an adult population is not useful in determining the prevalence of diabetes mellitus.

Prevalence of diabetes mellitus and impaired glucose tolerance in a rural Palestinian population.

The prevalence of diabetes mellitus and impaired glucose tolerance was investigated in a cross-sectional population-based study in a rural Palestinian population of 500 females and males aged 30-65 years. The prevalence of diabetes was 9.6% and 10.0% in females and males respectively. The prevalence of impaired glucose tolerance was 8.6%; 10.3% in females, 6.2% in males. The prevalence of total glucose intolerance (diabetes mellitus + impaired glucose tolerance) was 18.4%. Our study provides the first baseline data on diabetes mellitus and impaired glucose tolerance in Palestine. The results indicate a high prevalence of glucose intolerance, information that is essential for the implementation of national planning and service provision.

The effect of smoking on periodontal conditions assessed by CPITN.

One hundred eighty subjects were examined to assess the effect of smoking on periodontal conditions by community periodontal index for treatment needs (CPITN). All subjects were interviewed regarding their oral hygiene habits. Data were entered to the computer and statistical analysis system (SAS) was utilised. Results showed that the frequency of smokers is 31% where 25.9% of this were male. Smokers use toothbrush in performing their oral hygiene more than non-smokers. Results also showed that periodontal conditions as measured by CPITN were not significantly different between smokers and non-smokers. However, further studies with more sensitive periodontal indices are recommended in the future to assess the differences between both groups.

Comparison of the clinical effects of subgingival application of metronidazole 25% gel and scaling in the treatment of adult periodontitis.

OBJECTIVE: Control of subgingival plaque is of paramount importance in the treatment of periodontal diseases. The role of subgingival sustained-release antibiotic therapy needs elucidation. A single-blind clinical trial was carried out in 13 patients with adult periodontitis to compare the effects of subgingival application of metronidazole dental gel with those of subgingival scaling. METHOD AND MATERIALS: A split-mouth design was used so that each patient received all treatments simultaneously. Randomly selected quadrants were treated with application of 25% metronidazole gel, subgingival scaling, or a combination of scaling and gel application. The remaining quadrant in each patient was left untreated as a control. RESULTS: All three treatments were effective in significantly reducing Plaque Index, Gingival Index, and bleeding on probing over the 14-week observation period. No statistically significant differences were found between scaling alone and combined treatment. Scaling and combined treatment were better than metronidazole. Metronidazole produced transient effects, best noted during the first 4 weeks after treatment. No additive effect of metronidazole was noted in the combined treatment. At week 14, only combined treatment sites and scaled sites showed statistically greater probing depth reduction than control sites. CONCLUSION: For the treatment of mild-to-moderate adult periodontitis, subgingival scaling alone is as effective as the combination of scaling and antibiotic therapy.