TY - JOUR
T1 - Standardized screening for periodontitis as an integral part of multidisciplinary management of adults with type 2 diabetes
T2 - An observational cross-sectional study of cohorts in the USA and UK
AU - Pumerantz, Andrew S.
AU - Bissett, Susan M.
AU - Dong, Fanglong
AU - Ochoa, Cesar
AU - Wassall, Rebecca R.
AU - Davila, Heidi
AU - Barbee, Melanie
AU - Nguyen, John
AU - Vila, Pamela
AU - Preshaw, Philip M.
N1 - Funding Information:
The authors thank all the patients who took part in the study as well as Vanessa Lopez for her assistance with data collection and aggregation. They also acknowledge the support of the UK National Institute for Health Research, through the Newcastle NIHR Dental Clinical Research Facility.
Publisher Copyright:
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Objective To determine prevalence and factors predictive of periodontitis by using a standardized assessment model in adults with type 2 diabetes. Research design and methods We performed an observational cross-sectional study to determine the burden of periodontitis in adults with type 2 diabetes attending urban, ambulatory referral centers in the USA and UK. Full-mouth probing was performed and periodontitis was diagnosed based on either a low (≥5 mm at ≥1 site) or high pocket probing-depth threshold (≥6 mm at ≥1 site). Results were stratified into a five-stage schema and integrated with other clinical variables into the novel Diabetes Cross-Disciplinary Index to function as a balanced health scorecard. Corresponding demographic and routinely collected health data were obtained and comparisons were made between patients with and without periodontitis. Multivariable logistic regression was performed to identify factors predictive of the presence or absence of periodontitis. Results Between our two cohorts, 253 patients were screened. Caucasians comprised >90% and Hispanic Americans >75% of the UK and US cohorts, respectively. Males and females were equally distributed; mean age was 53.6±11 years; and 17 (6.7%) were edentulous. Of the 236 dentate patients, 128 (54.2%) had periodontitis by low threshold and 57 (24.2%) by high threshold. Just 17 (7.2%) were periodontally healthy. No significant differences in age, HbA1c, blood pressure, body mass index, low-density lipoprotein cholesterol, or smoking status (all p>0.05) were identified between those with or without periodontitis (regardless of threshold) and none was found to be a significant predictor of disease. Conclusions Periodontitis is frequent in adults with type 2 diabetes and all should be screened. Periodontal health status can be visualized with other comorbidities and complications using a novel balanced scorecard that could facilitate patient–clinician communication, shared decision-making, and prioritization of individual healthcare needs.
AB - Objective To determine prevalence and factors predictive of periodontitis by using a standardized assessment model in adults with type 2 diabetes. Research design and methods We performed an observational cross-sectional study to determine the burden of periodontitis in adults with type 2 diabetes attending urban, ambulatory referral centers in the USA and UK. Full-mouth probing was performed and periodontitis was diagnosed based on either a low (≥5 mm at ≥1 site) or high pocket probing-depth threshold (≥6 mm at ≥1 site). Results were stratified into a five-stage schema and integrated with other clinical variables into the novel Diabetes Cross-Disciplinary Index to function as a balanced health scorecard. Corresponding demographic and routinely collected health data were obtained and comparisons were made between patients with and without periodontitis. Multivariable logistic regression was performed to identify factors predictive of the presence or absence of periodontitis. Results Between our two cohorts, 253 patients were screened. Caucasians comprised >90% and Hispanic Americans >75% of the UK and US cohorts, respectively. Males and females were equally distributed; mean age was 53.6±11 years; and 17 (6.7%) were edentulous. Of the 236 dentate patients, 128 (54.2%) had periodontitis by low threshold and 57 (24.2%) by high threshold. Just 17 (7.2%) were periodontally healthy. No significant differences in age, HbA1c, blood pressure, body mass index, low-density lipoprotein cholesterol, or smoking status (all p>0.05) were identified between those with or without periodontitis (regardless of threshold) and none was found to be a significant predictor of disease. Conclusions Periodontitis is frequent in adults with type 2 diabetes and all should be screened. Periodontal health status can be visualized with other comorbidities and complications using a novel balanced scorecard that could facilitate patient–clinician communication, shared decision-making, and prioritization of individual healthcare needs.
KW - Diabetes management
KW - Targeted screening
KW - type 2 diabetes
KW - Medical risk factors
UR - http://www.scopus.com/inward/record.url?scp=85022344810&partnerID=8YFLogxK
U2 - 10.1136/bmjdrc-2017-000413
DO - 10.1136/bmjdrc-2017-000413
M3 - Article
AN - SCOPUS:85022344810
SN - 2052-4897
VL - 5
JO - BMJ Open Diabetes Research and Care
JF - BMJ Open Diabetes Research and Care
IS - 1
M1 - e000413
ER -
