Richard C. Oliver

Diabetes–A Risk Factor for Periodontitis in Adults?

With the increasing number of diabetics in an aging population and controversial research reports on the relationship of diabetes to periodontitis, clarification of diabetes as a risk factor for periodontitis would be helpful. This review notes variations in type, metabolic control, and duration of diabetes and highlights the results of studies that have considered these variations. Diabetics who maintained reasonably good metabolic control had not lost more teeth or experienced more periodontal attachment loss than non-diabetics, although they had more periodontal pockets. Poorly-controlled diabetics with extensive calculus on their teeth had more periodontitis and tooth loss than well-controlled diabetics or non-diabetics. Long-duration diabetics were also at greater risk for periodontitis. Mechanisms by which diabetes may contribute to periodontitis include vascular changes, neutrophil dysfunction, altered collagen synthesis, and genetic predisposition. Minimizing plaque and calculus in the oral cavity through careful self-care and regular professional care is important to reduce the risk of periodontitis in diabetics. J Periodontol 1994; 65:530-538.

Variations in the Prevalence and Extent of Periodontitis

A national survey of employed adults showed a decrease in the extent and severity of periodontal disease in comparison with findings from earlier studies. Using data from that survey, this report evaluates the association of socioeconomic factors--race, education, income and dental insurance, as well as most recent dental visit--with the prevalence and extent of periodontal disease. Periodontitis was more prevalent and usually more extensive in persons who are black, have less education or had not seen a dentist in three or more years. Having dental insurance was not associated with better periodontal health.