Compromised periodontal status in an urban Sri Lankan population with type 2 diabetes.

AIM: To determine the prevalence of periodontitis in an urban population of Sri Lankans with type 2 diabetes (T2DM) and to compare the data with those from a population of adults without diabetes. METHODS: Demographic data and a diabetes profile were recorded for a population of urban Sri Lankan adults with T2DM including duration of diabetes, blood pressure; percentage glycosylated haemoglobin, fasting blood glucose level, total cholesterol; triglycerides, low- and high-density lipoproteins. The clinical examination comprised an oral soft tissue examination, full-mouth probing depths (PD), gingival recession (GR), clinical attachment levels and bleeding on probing (BoP). RESULTS: Two hundred and eighty-five individuals with T2DM and 72 controls were examined. 33.3% of T2DM patients were diagnosed with chronic periodontitis compared with 21.7% of controls (p=0.077). Subjects with T2DM had significantly more sites with PD>or=4 and >or=5 mm (p<0.01), and higher mean GR and BoP scores (p<0.01). CONCLUSION: This urban Sri Lankan population of subjects with T2DM demonstrated a compromised periodontal status compared with non-diabetic controls.

Does tooth brushing influence the development and progression of non-inflammatory gingival recession? A systematic review.

AIM: The aim of this systematic review was to produce the best available evidence and pool appropriate data to evaluate the effect of tooth brushing on the initiation and progression of non-inflammatory gingival recession. MATERIAL AND METHODS: A protocol was developed a priori for the question: "Do factors associated with tooth brushing predict the development and progression of non-inflammatory gingival recession in adults?" The search covered six electronic databases between January 1966 and July 2005. Hand searching included searches of the Journal of Clinical Periodontology, Journal of Periodontal Research and the Journal of Periodontology. Bibliographies of narrative reviews, conference proceedings and relevant texts known to the authors were also searched. Inclusion of titles, abstracts and ultimately full texts was based on consensus between three reviewers. RESULTS: The full texts of 29 papers were read and 18 texts were eligible for inclusion. One abstract from EuroPerio 5 reported a randomized-controlled clinical trial [Level I evidence] in which the authors concluded that the toothbrushes significantly reduced recessions on buccal tooth surfaces over 18 months. Of the remaining 17 observational studies, two concluded that there appeared to be no relationship between tooth brushing frequency and gingival recession. Eight studies reported a positive association between tooth brushing frequency and recession. Other potential risk factors were duration of tooth brushing, brushing force, frequency of changing the toothbrush, brush (bristle) hardness and tooth brushing technique. None of the observational studies satisfied all the specified criteria for quality appraisal and a valid appraisal of the quality of the randomized-controlled trial was not possible. CONCLUSION: The data to support or refute the association between tooth brushing and gingival recession are inconclusive.