Association between periodontitis and glycated hemoglobin levels in individuals living in rural Southern Brazil.

OBJECTIVES: To estimate the prevalence of prediabetes in individuals with moderate or severe periodontitis and to verify the association between periodontitis and glycated hemoglobin levels. MATERIAL AND METHODS: A cross-sectional study was conducted including individuals age 18-93 years from a representative sample residing in rural Southern Brazil. Data collection included full mouth periodontal clinical examinations, laboratory screens, and structured questionnaires. Glycemic levels were based on glycated hemoglobin. Periodontitis case definition was based on criteria established by the Centers for Disease Control and Prevention and the American Academy of Periodontology. A logistic regression model adjusted for body mass index was used to estimate odds ratios (OR) and 95% confidence intervals (CI). The association between periodontal parameters and changes in glycated hemoglobin levels was evaluated using linear regression models. RESULTS: A higher prevalence of prediabetes was observed among individuals with moderate (39.6%) and severe periodontitis (49.7%) than in individuals with mild (23.8%) or no periodontitis (27.8%). Adjusting for body mass index, individuals with severe periodontitis exhibited a 2.5 greater chance of being prediabetic (OR=2.5; 95% CI: 1.3-4.9) that was significantly associated with an increase of 0.10% in HbA1c. CONCLUSION: Severe periodontitis was associated with elevated blood glucose levels. Individuals with this condition having a higher percentage HbA1c are more likely to be prediabetic. CLINICAL RELEVANCE: This study highlights the importance of the clinicians' awareness of the association between severe periodontitis and prediabetes allowing its early detection in the dental office.

The 2018 EFP/AAP periodontitis case classification demonstrates high agreement with the 2012 CDC/AAP criteria.

AIM: To investigate the agreement between the 2018 EFP/AAP periodontitis case classification and the 2012 CDC/AAP criteria. MATERIALS AND METHODS: This cross-sectional study assessed a population-based sample from a rural area in southern Brazil. A complete periodontal examination was performed at six sites/tooth. The periodontitis case definition was estimated and compared according to the 2018 EFP/AAP classification and the 2012 CDC/AAP criteria (reference). Diagnostic tests included sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and area under ROC curve (AUC). RESULTS: Five hundred and eighty-eight subjects with ≥6 teeth each were included. Based on the 2018 EFP/AAP classification, 71.1% of the subjects were classified as stage III/IV showing 100% agreement with 2012 CDC/AAP criteria for the severe category. For the moderate and severe classification, the 2018 EFP/AAP SN was 99.8% and 100%, SP 13.6% and 43.6%, PPV 83.4% and 47.4%, and NPV 93.7% and 100%, respectively. The AUC was 0.9059 (95% CI = 0.879-0.933) and the optimal cut-off based on the curve was stage III. CONCLUSIONS: The 2018 EFP/AAP periodontitis case classification showed high agreement with the 2012 CDC/AAP criteria in a rural sample with high periodontitis occurrence.