LONG-TERM CONTROL OF DIABETES-MELLITUS AND PERIODONTITIS

The purpose of this study was to evaluate the association between long -term control of diabetes mellitus (DM) and periodontitis. A total of 75 diabetics (Type I or II) aged 20-70 years with long-term records of their diabetic control were selected for the study. The following per iodontal variables were recorded in a randomized half-mouth examinatio n: plaque, calculus (+/-), probing depth (pd) and attachment loss (al) . The mean of glycosylated hemoglobin measurements (HbAlc) over the pa st 2-5 years was used to indicate the long-term control of DM. The stu dy participants were divided into well-, moderately- and poorly-contro lled diabetics. An increase in the prevalence, severity and extent of periodontitis with poorer control of diabetes was observed. The extent of calculus also increased with poorer control. In a multiple regress ion analysis, calculus and long-term control of diabetes were signific ant variables when pd greater-than-or-equal-to 4 mm was used as the de pendent variable. Age was a significant predictor for al greater-than- or-equal-to 3 mm but not for pd greater-than-or-equal-to 4 mm. Sex, du ration and type of DM were not significant variables in the regression models. Less than 2% of sites with no calculus demonstrated pd greate r-than-or-equal-to 4 mm. When calculus was present, the frequency of p d greater-than-or-equal-to 4 mm increased from 6% in the well-controll ed diabetics to 16% in the poorly-controlled ones. We conclude that pe riodontitis in diabetics is associated with long-term metabolic contro l and presence of calculus. Therefore, regular maintenance care, inclu ding patient motivation and instruction as well as professional calcul us removal, is important for diabetic patients.