Association between numbers of decayed teeth and HbA1c in Japanese patients with type 2 diabetes mellitus

Abstract

BackgroundDental caries (DC) are more prevalent in individuals with diabetes than in healthy individuals. However, the association between glycaemic control and DC has not been well characterized in patients with type 2 diabetes mellitus (T2DM). We therefore assessed the association between glycated haemoglobin (HbA1c) serum concentrations and the prevalence of DC in patients with T2DM.MethodsRetrospective analyses of data pertaining to 108 Japanese patients with T2DM hospitalized because of poor or worsened glycaemic control were included. We divided the patients based on HbA1c into two groups: HbA1c level ≥75 mmol/mol (9.0%) as poorly controlled T2DM, and HbA1c level <75 mmol/mol (9.0%) as a control group. We compared the association of lifestyle factors, dental caries, and periodontal health between patients with poorly controlled T2DM and controls. Stepwise multiple regression analyses were performed to evaluate the association between HbA1c, the absolute number of decayed teeth (DT), the sum of decayed, missing, and filled teeth, and the Met Need Index (MNI).ResultsDT was higher and MNI was lower in patients with poorly controlled T2DM as compared to that in controls (P = 0.006 and P = 0.004, respectively). Multiple regression analyses revealed a significant association between HbA1c levels and DT (adjusted β = 0.039, 95% confidence interval [CI], 0.005 to 0.072, P = 0.025) and the MNI (adjusted β = −0.216, 95% CI −0.374 to −0.058, P = 0.008).ConclusionsDT and MNI were associated with HbA1c in T2DM patients.

Analysis of the Relationship between Oral Diseases and Glycemic Control of Diabetes in the West African Context: Survey at the Centre Anti-Diab&#233;tique d’Abidjan (CADA), C&#244;te d’Ivoire

“…These results are in agreement with Collin et al [41] and Edblad et al [42] who didn't find a relationship between tooth decay and diabetes balance, but in total contradiction with Twetman's study, which showed that diabetics with poor glycemic control developed three times more carious lesions than those with better glycemic control [43]. This statement is supported by Satoru et al who found a significant association between the number of decayed teeth and high levels of glycosylated hemoglobin (HbA1c) [44], which is the main marker of glycemic control in diabetes. Although the data on the relationship between dental caries and diabetes are still contradictory, it is clear that oral environmental disturbances induced by high blood sugar levels, such as a disruption of the oral flora in favour of cariogenic bacteria, a decrease in pH and salivary flow, changes in the composition of saliva, which thus loses its protective powers (anti-infectious and against caries) within the oral cavity, as well as high concentrations of glucose in saliva and gingival fluid in these patients are likely to increase the risk of dental caries [45] [46].…”

Potential risk factors for dental caries in Type 2 diabetic patients

“…Comparing patients with T2D with a control group, there were statistically significant differences in missing teeth, calculus, probing depth and attachment level, whereas these variables did not differ significantly between type 1 diabetes and controls . Previous studies on T2D patients from different ethnicities have shown variable prevalence of dental caries . Despite alarmingly high prevalence of diabetes in Saudi Arabia, there is hardly any report on the frequency of dental caries in this subgroup.…”

IDF Diabetes Atlas: Diabetes and oral health – A two-way relationship of clinical importance

“…The evidence for links between hyperglycemia and caries is inconclusive in children with type 1 diabetes [31], as well as people of all ages with hyperglycemia. Some researchers find diabetes [11,32,33] or elevated glucose levels in saliva [13,34], or in serum [35] to be associated with more caries, while others find no difference [12,36]. Children with type 1 diabetes in good metabolic control might even be considered at low caries risk, while those with poor metabolic control show a more acidic oral environment prone to a high risk of caries [37].…”

“…Even though people with diabetes do not necessarily have more caries [12], except possibly if diabetes is poorly controlled [33,35], they experience greater risk of periapical lesions in the jaw bone that seem to be present more often and to be larger in size and take longer to heal compared to normo-glycemic people [38][39][40][41], especially when poorly controlled [42]. The result of untreated caries is eventually the necrosis of the pulp (''nerve") inside the tooth, upon which the various substances from the breakdown of the dead nerves, blood, and connective tissue discharge out through the end of the root of the tooth (apex) and into the surrounding jaw bone and into the systemic blood stream.…”