Clinical Utility of Self-Reported Oral Health Measures for Predicting Periodontitis Among Adult Filipinos with Type 2 Diabetes Mellitus
Keywords:
Oral Health Questionnaire, periodontitis, type 2 diabetes mellitus, dental careAbstract
*Visual Abstracts prepared by Dr. Carmen Carina Cabrera
Background. The likelihood of periodontitis among type 2 diabetes is thrice the non-diabetic population and progresses rapidly when uncontrolled. An inexpensive and easy way of dental assessment via self-reported oral health questionnaire has great potential as a screening tool.
Objective. This study aims to validate self-reported oral health measures, socio-demographic and medical variables in predicting the severity of periodontitis in Filipino adults with type 2 diabetes.
Methodology. The validated self-reported oral health questionnaires created by the CDC Periodontal Disease Surveillance Project was translated into Filipino and used. A cross-sectional study of 180 participants was conducted in a single institution. Multivariable logistic regression analyses were used to determine significant predictors of serious periodontitis.
Results. Male sex [OR=2.17], low educational status [OR=2.98], poor glycemic control [OR=2.58], less frequent dental visits [OR=2.77] and teeth loss >6 [OR=5.02] were considered to be predictive of serious periodontitis. Self reported oral health variables like gum disease –Q1 [OR=8.33], state of gum health –Q2 [OR=0.39], loose teeth –Q3 [OR=63.0], brushing of teeth –Q4 [OR=0.65], use of mouthwash –Q4 [OR=0.69] and poor tooth appearance –Q5 [OR=48.42] were also shown to be significantly predictive of serious periodontitis. A recommended set of questions and proposed scoring system based on the logistic regression analysis of each predictor’s strength was then formulated.
Conclusion. The use of specific self-reported oral health questions, certain socio-demographic and medical variables appeared to be highly predictive of serious periodontitis among Filipinos with type 2 diabetes. This provides a cost-effective and rapid method of screening patients who are in need of immediate dental evaluation.
Downloads
References
Zimmet P, Alberti KGMM, Shaw J. Global and societal implications of the diabetes epidemic. Nature. 2001;414:782–7. http://dx.doi.org/10.1038/414782a.
Global status report on noncommunicable diseases 2014. Geneva, World Health Organization, 2012.
Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010;87(1):4-14. http://dx.doi.org/10.1016/j.diabres.2009.10.007.
Soria MLB, Sy RG, Vega BS, Ty-Willing T, Abenir-Gallardo A, Velandria F, et al. The incidence of type 2 diabetes mellitus in the Philippines: A 9-year cohort study. Diabetes Res Clin Pract. 2009;86(2):130-3. http://dx.doi.org/10.1016/j.diabres.2009.07.014.
Chaudhari M, Hubbard R, Reid RJ, Inge R, Newton KM, Spangler L, et al. Evaluating components of dental care utilization among adults with diabetes and matched controls via hurdle models. BMC Oral Health. 2012;12:20. http://dx.doi.org/10.1186/1472-6831-12-20.
Yuen HK, Onicescu G, Hill EG, Jenkins C. A survey of oral health education provided by certified diabetes educators. Diabetes Res Clin Pract. 2010;88(1):48-55. http://dx.doi.org/10.1016/j.diabres.2009.12.015.
Newton KM, Chaudhari M, Barlow WE, Inge RE, Theis MK, Spangler LA, et al. A population-based study of periodontal care among those with or without diabetes. J Periodontol. 2011;82(12):1650-6. http://dx.doi.org/10.1902/jop.2011.100609.
Daniel R, Gokulanathan S, Shanmugasundaram N, Lakshmigandhan M, Kavin T. Diabetes and periodontal disease. J Pharm Bioallied Sci. 2012;4(6):280-2. http://dx.doi.org/10.4103/0975-7406.100251.
Löe H. Periodontal disease: The sixth complication of diabetes mellitus. Diabetes Care. 1993;16(1):324–34. http://dx.doi.org/10.2337/diacare.16.1.329.
The pathogenesis of periodontal diseases. J Periodontol. 1999;70(4):457–70.
Mealey BL, Oates TW. Diabetes mellitus and periodontal diseases. J Periodont. 2006;77(8):1289–1303. http://dx.doi.org/10.1902/jop.2006.050459.
Glavind L, Lund G, Löe H. The relationship between periodontal state and diabetes duration, insulin dosage and retinal changes. J Periodontol. 1968;39(6):341-7. http://dx.doi.org/10.1902/jop.1968.39.6.341.
Apoorva SM, Sridhar N, Suchetha A. Prevalence and severity of periodontal disease in type 2 diabetes mellitus (non–insulin-dependent diabetes mellitus) patients in Bangalore city: An epidemiological study. J Indian Soc Periodontol. 2013;17(1):25-9. http://dx.doi.org/10.4103/0972-124X.107470.
Bharateesh JV, Ahmed M, Kokila G. Diabetes and oral health: A case-control study. Int J Prev Med. 2012;3(11):806-9.
Weinspach K, Staunfenbiel I, Memenga-Nicksch S, Ernst S, Geurtsen W, Günay H. Level of information about the relationship between diabetes mellitus and periodontitis- Results from a nationwide diabetes information program. Eur J Med Res. 2013;18:6.
Bitong E, Jasul GV, Dellosa MAG. Prevalence of periodontitis and its association with glycemic control among patients with type 2 diabetes mellitus seen at St.Luke’s Medical Center. Philipp J Int Med. 2010;48(1):9-14.
Lee IC, Shieh TY, Yang YH, Tsai CC, Wang KH. Individuals’ perception of oral health and its impact on the health-related quality of life. J Oral Rehabil 2007;34(2):79–87. http://dx.doi.org/10.1111/j.1365-2842.2006.01694.x.
Sandberg GE, Wikblad KF. Oral health and health-related quality of life in type 2 diabetic patients and non-diabetic controls. Acta Odontol Scand. 2003;61:141–8.
Teeuw WJ, Gerdes VEA, Loos BG. Effect of periodontal treatment on glycemic control of diabetic patients. Diabetes Care. 2010;33(2):421-7. http://dx.doi.org/10.2337/dc09-1378.
Tomar SL, Lester A. Dental and other health care visits among U.S. adults with diabetes. Diabetes Care. 2000;23(10):1505–10. http://dx.doi.org/10.2337/diacare.23.10.1505.
Ofilada EJ ,Jimeno CA. A Survey on the barriers to dental care among individuals with type 1 diabetes mellitus. Ongoing publication. 2013.
O’Connor PJ, Desai J, Rush WA, Cherney LM, Solberg LI, Bishop DB. Is having a regular provider of diabetes care related to intensity of care and glycemic control? J Fam Prac. 1998;47(4):290–7.
IDF Clinical Guideline Taskforce. IDF guideline on oral health for people with diabetes. Brussels: International Diabetes Federation, 2009.
Jimeno CA. Updates on the UNITE for Diabetes Philippine Practice Clinical Practice Guidelines for Diabetes Part 2. PPD Compendium of Philippine Medicine, 2014.
Eke PI, Genco RJ. CDC periodontal disease surveillance project: Background, objective, and progress report. J Periodontol. 2007;78(7s):1366-71. http://dx.doi.org/10.1902/jop.2007.070134.
Miller K, Eke PI, Schoua-Glusberg A. Cognitive evaluation of self-report questions for surveillance of periodontitis. J Periodontol. 2007;78(7s):1455-62. http://dx.doi.org/10.1902/jop.2007.060384.
Slade G. Interim analysis of validity of periodontitis screening questions in the Australian population. J Periodontol. 2007;78(7s):1463-70. http://dx.doi.org/10.1902/jop.2007.060344.
Eke PI, Dye B. Assessment of self-report measures for predicting population prevalence of periodontitis. J Periodontol 2009;80(9):1371-9. http://dx.doi.org/10.1902/jop.2009.080607.
American Diabetes Association. Standards of medical care in diabetes- 2013. Diabetes Care. 2013;36(1):S11-S66. http://dx.doi.org/10.2337/dc13-S011.
Dye BA, Barker LK, Selwitz RH, Lewis BG, Wu T, Fryar CG, et al. Overview and quality assurance for the National Health and Nutrition Examination Survey (NHANES) oral health component, 1999-2002. Community Dent Oral Epidemiol. 2007;35(2):140-51. http://dx.doi.org/10.1111/j.1600-0528.2007.00310.x.
Tomar SL, Asma S. Smoking-attributable periodontitis in the United States: Findings from NHANES III. J Periodontol. 2000;71(5):74351. http://dx.doi.org/10.1902/jop.2000.71.5.743.
Albandar JM, Brunelle JA, Kingman A. Destructive periodontal disease in adults 30 years of age and older in the United States, 1988-1994. J Periodontol. 1999;70(1):13-29. http://dx.doi.org/10.1902/jop.1999.70.1.13.
Swets JA. Measuring the accuracy of diagnostic systems. Science. 1988;240(4857):1285-93. http://dx.doi.org/10.1126/science.3287615.
Nelson DE, Holtzman D, Bolen J, Stanwyck CA, Mack KA. Reliability and validity of measures from the Behavioral Risk Factor Surveillance System (BRFSS). Soz Praventivmed. 2001;46 (1):S3- S42.
Published
How to Cite
Issue
Section
License
Journal of the ASEAN Federation of Endocrine Societies is licensed under a Creative Commons Attribution-NonCommercial 4.0 International. (full license at this link: http://creativecommons.org/licenses/by-nc/3.0/legalcode).
To obtain permission to translate/reproduce or download articles or use images FOR COMMERCIAL REUSE/BUSINESS PURPOSES from the Journal of the ASEAN Federation of Endocrine Societies, kindly fill in the Permission Request for Use of Copyrighted Material and return as PDF file to jafes@asia.com or jafes.editor@gmail.com.
A written agreement shall be emailed to the requester should permission be granted.
