Periodontal disease and diabetes are widespread comorbid conditions that are detrimental
to oral and overall health. Dentists’ performing chairside screenings for undiagnosed
diabetes mellitus (UDM) can be beneficial to both patients and providers. The authors
determined UDM rates in a population-based study and whether UDM and periodontal disease
were independently associated.
Data from 7,343 participants in the Atherosclerosis Risk in Communities study visit
4 were used to determine rates of UDM by periodontal status, edentulism, and body
mass index. The authors used a χ
2 test or analysis of variance, along with a 2-stage logistic regression model, to
determine relationships with UDM. UDM was defined as no self-reported diabetes and
blood glucose levels (fasting glucose ≥ 126 milligrams/deciliter or nonfasting glucose
> 200 mg/dL). Periodontal disease was defined using the Periodontal Profile Classes
system adapted to stages and the Centers for Disease Control and Prevention and American
Academy of Periodontology index.
UDM rates overall were 5.6%. The highest rates occurred in patients who were obese
and edentulous (12.6%) and obese and had severe periodontal disease (12.2%). Significant
associations were found for UDM and severe periodontal disease (Periodontal Profile
Classes system stage IV) (odds ratio, 1.78; 95% confidence interval, 1.10 to 2.88).
Edentulism was significantly associated with UDM in the Periodontal Profile Classes
system model (odds ratio, 1.87; 95% confidence interval, 1.27 to 2.75) and Centers
for Disease Control and Prevention and American Academy of Periodontology index (odds
ratio, 1.70; 95% confidence interval, 1.08 to 2.67). Hyperglycemia was found in participants
of all body mass index categories.
UDM is significantly associated with obesity, edentulism, and periodontitis. These
characteristics could help dentists identify patients at higher risk of developing
DM. Patients without these characteristics still have UDM, so dentists performing
chairside diabetes screening for all patients would yield additional benefit.
Dental offices are a major point of contact within the US health care system. Diabetes
screening in this setting can provide important health information with direct relevance
to patient care.