Association between periodontal condition and the development of type 2 diabetes mellitus-Results from a 15-year follow-up study.

AIM: To study whether periodontal condition is associated with the development of type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: A population-based follow-up study was conducted among persons born in 1935 and living in the city of Oulu, Finland (n = 395). The baseline examinations were done during 1990-1992, and the follow-up examinations were done during 2007-2008. The data were gathered by questionnaires, laboratory tests and clinical measurements. Poisson regression models were used in the data analyses. RESULTS: The adjusted rate ratios (RR) with 95% confidence intervals (95% CI) for the incident T2DM among subjects with 4-5 mm deep periodontal pockets (n = 98), among subjects with 6 mm deep or deeper periodontal pockets (n = 91), and among edentulous subjects (n = 118) were 1.32 (95% CI: 0.69-2.53), 1.56 (95% CI: 0.84-2.92) and 1.00 (95% CI: 0.53-1.89), respectively, compared to dentate subjects without deepened (4 mm deep or deeper) periodontal pockets (n = 88). The adjusted RR per site (the number of sites with deepened periodontal pockets as a continuous variable) was 1.02 (95% CI: 1.00-1.04). CONCLUSIONS: Poor periodontal condition may be a predictor of the development of T2DM. However, the causality between periodontal condition and the development of T2DM remains uncertain.

Periodontal infection and subclinical atherosclerosis: the role of high-density lipoprotein as a modifying factor.

BACKGROUND: Periodontitis is suggested to enhance the process of vascular inflammation leading to atherosclerosis. The purpose was to study the relation between periodontal infection and subclinical atherosclerosis, and whether this relation is dependent on high-density lipoprotein (HDL) cholesterol levels. METHODS: A secondary analysis of the data of a diabetic study, confined to 60 dentate subjects who underwent clinical examinations in 1990-1992 and in 1996-1998, was carried out. Ultrasonographic measurements of carotid, aortic and femoral atherosclerosis were performed in 2000. RESULTS: No consistent association was found between the presence of periodontal pockets and subclinical atherosclerosis in the total population, but a fairly strong association was found among subjects with a low HDL level, whereas in subjects with a high HDL level, an opposing and less consistent association was found. Product terms indicating a possible modification by HDL were statistically significant (at p=0.05 level) for total plaques with all cut-off values, for plaques in carotid arteries with cut-off values 1.2-1.4 and for intima-media thickness with cut-off values of 1.1-1.2, but not for aorta plaques. CONCLUSIONS: HDL levels or factors closely associated with HDL levels appear to modify the association between periodontal infection and certain parameters of subclinical atherosclerosis.

Symptoms of depression and anxiety in relation to dental health behavior and self-perceived dental treatment need.

The purpose of this study was to investigate the dental health behavior and self-perceived dental treatment need, in relation to depressive symptoms and symptoms of anxiety, among a general population drawn from a sample of 31-yr-old-men and women born in Northern Finland in 1966 (n = 8463). The dental health behavior included toothbrushing frequency and the frequency of dental check-ups. Depressive symptoms, as well as symptoms of anxiety, were determined on the basis of the Symptom Checklist-25 (SCL-25). The participants were also asked about their education and family income. Subjects with a high number of depressive symptoms had lower toothbrushing frequency as well as a lower frequency of dental visits than subjects with no or only a few depressive symptoms. Morover, the self-perceived dental treatment need was more common among those with a high number of depressive symptoms. Symptoms of anxiety were significantly associated with lower toothbrushing frequency. The results support the view that there is an increased risk for impaired dental health among subjects with depressive symptoms or symptoms of anxiety.