ASSOCIATION OF THE SEVERITY OF PERIODONTAL-DISEASE WITH ORGAN COMPLICATIONS IN TYPE-1 DIABETIC-PATIENTS

THIS STUDY EXAMINED THE RELATIONSHIP BETWEEN THE SEVERITY Of periodont al disease and organ complications in long-term Type 1 or insulin-depe ndent diabetes mellitus patients, taking account of the severity and c oncomitant existence of these complications. The population studied co nsisted of 26 Type 1 diabetics 26 to 34 years old, who had had diabete s for at least 10 years. Severity of periodontal disease was shown to increase with severity of organ complications. Patients with advanced complications had significantly more bleeding on probing, pockets grea ter than or equal to 4 mm deep, and more attachment loss than patients with incipient complications or no complications. Stepwise multiple r egression analysis showed that the existence of advanced complications was the only diabetes-related factor predicting pockets greater than or equal to 4 mm deep. Subgingival calculus, sex, and smoking were oth er significant variables. Retinopathy was the organ complication most suited to comparison, since it is usually the first to appear and can easily be classified from nonexistent to severe. Differences in severi ty of periodontal disease were less obvious if metabolic balance alone was considered than between subgroups formed on the basis of the exis tence of advanced complications. Severity of periodontal disease and t he existence of complications were more closely related to long-term g lucose balance than single, most recent HbA(1) values. Prevalence of p ockets at sites with subgingival calculus increased with severity of c omplications. Indicators of dental-health behavior, including amount o f plaque, subgingival calculus, home-care practices, and regularity of visits to the dentist, were worse in subjects with poor control and c omplications. Our results suggest that attention needs to be paid to T ype 1 diabetes of long-standing disease with poor long-term glucose co ntrol, particularly those with organ complications.