Periodontal Disease as a Predictor of Undiagnosed Diabetes or Prediabetes in Dental Patients

Heji, Esraa S.; Bukhari, Abdullah; Bahammam, Manal A.; Homeida, Lujain; Aboalshamat, Khalid; Aldahlawi, Salwa

doi:10.1055/s-0040-1719208

Cited by 14 publications

(19 citation statements)

References 37 publications

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“…3 Among the factors that increase the risk of severe outcomes and mortality, 4 cardiovascular diseases, cancer, obesity, and diabetes have also been reported to be associated with periodontal diseases. 5 6 7 8 9 10 In this context, the potential relationship between COVID-19 and periodontal diseases has become of major interest and many papers have been published on this issue. The aim of the present scoping review was not only to present the published data regarding potential relationships between periodontal diseases and COVID-19 but also to highlight any gaps in the existing literature.…”

Section: Introductionmentioning

confidence: 99%

Periodontal Diseases and COVID-19: A Scoping Review

Basso

Chacun

et al. 2021

Eur J Dent

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The aim of this scoping review was to present the existing literature regarding the relationship between periodontal diseases and coronavirus disease 2019 (COVID-19). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping review guidelines was followed. Articles were retrieved from PubMed/MEDLINE and Scopus databases and screened to include studies relating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 to periodontal cells and/or tissues and/or diseases. Twenty-five papers were included; consisting of six reviews, seven original articles, six short reports, four letters to the editor, one commentary, and one case report. The articles were allocated to three different topics: (i) hypotheses on the relationship between periodontal diseases and COVID-19; (ii) risk factors and comorbidities common to periodontitis and COVID-19; (iii) periodontal manifestations of COVID-19. Certain molecules (angiotensin-converting enzyme-2, furin, cathepsin, TMPRSS2...) that are found at a high level in periodontal tissues, particularly in patients with periodontitis, are involved in the mechanism of entry of SARS-CoV-2 into cells. Periodontopathic bacteria could also play a direct role in the mechanism of entry of SARS-CoV-2 by cleaving the S-protein, and the cytokines produced during periodontitis could add to the cytokine storm found in the severe forms of COVID-19. It thus appears that the treatment of periodontitis, which allows a reduction in periodontopathic bacteria and of the local and systemic inflammation state, could be part of a strategy to prevent the development of severe forms of COVID-19.

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Section: Introductionmentioning

confidence: 99%

Periodontal Diseases and COVID-19: A Scoping Review

Basso

Chacun

et al. 2021

Eur J Dent

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“…Severe periodontal disease may be a warning sign of undiagnosed diabetes [ 9 ]. Periodontal treatment can reduce glycemia among diabetic patients [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

US adults with diabetes mellitus: Variability in oral healthcare utilization

et al. 2021

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Background Diabetic patients are advised to have at least one dental examination per year. It is unclear to what extent different subgroups of US diabetic adults closely follow this recommendation. Thus, we assessed dental care utilization and related factors in a representative sample of US diabetic adults from rural and urban counties. Methods Cross-sectional data were from the 2018 Behavioral Risk Factor Surveillance System (BRFSS). Survey logistic regression was used to account for the complex sampling design. Results Among 40,585 eligible participants, 24,887 (60% of the population) had at least one dental visit for any reason within the past year. The lowest compliance was observed among edentulous participants (27%, adjusted OR = 0.26, 95% CI = 0.22–0.31 vs. fully dentate). Dental compliance was also negatively associated with having a lower income or education, ever being a smoker, or having barriers to access to care. Rural residents had lower dental compliance compared to urban residents, particularly those without healthcare coverage. Conclusions Dental compliance among US adult diabetic individuals was low, particularly among rural residents, and as compared to other recommended diabetic care practices. Future public health interventions may target rural individuals without healthcare coverage, smokers and edentulous individuals. There is a need to integrate dental and medical care to facilitate cross-talks among different health professionals, so that educational preventive messages are reinforced at every healthcare visit.

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“…All studies but one (Lalla et al, 2011) had less than 10 events per variable. In addition, four studies did not include all participants in the analysis (Herman et al, 2015; Hegde et al, 2019; Heji et al, 2020; Su et al, 2020), three dichotomized periodontal predictors using arbitrary thresholds (Herman et al, 2015; Holm et al, 2016; Montero et al, 2021), three used an inappropriate method to select predictors for inclusion in the model (Holm et al, 2016; Grigoriadis et al, 2021; Montero et al, 2021) and one did not account for the complexities in the data, namely sampling fractions in a case–control study (Hegde et al, 2019). Finally, the two studies that reported a PPM (Lalla et al, 2011; Montero et al, 2021) did not assess model performance in terms of both discrimination and calibration, did not account for model overfitting and optimism and did not report the weights assigned to predictors for clinical use.…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies were conducted in Western countries, namely three in the United States (Lalla et al, 2011; Herman et al, 2015; Hegde et al, 2019) and one each in Denmark (Holm et al, 2016), Greece (Grigoriadis et al, 2021), the Netherlands (Su et al, 2020) and Spain (Montero et al, 2021). The remaining study was from Saudi Arabia (Heji et al, 2020). While most studies collected primary data, one study used existing data from electronic health records (Hegde et al, 2019).…”

Section: Resultsmentioning

confidence: 99%

“…While most studies collected primary data, one study used existing data from electronic health records (Hegde et al, 2019). Seven studies developed PPMs for undiagnosed hyperglycaemia (Lalla et al, 2011; Herman et al, 2015; Holm et al, 2016; Heji et al, 2020; Su et al, 2020; Grigoriadis et al, 2021; Montero et al, 2021) and one for diabetes (Hegde et al, 2019). Clinical periodontal measures were evaluated in all studies; however, some used partial‐mouth examinations (Herman et al, 2015; Su et al, 2020; Montero et al, 2021), did not measure clinical attachment loss (Herman et al, 2015; Lalla et al, 2011; Su et al, 2020) or did not report the reliability of examiners (Lalla et al, 2011; Herman et al, 2015; Holm et al, 2016; Hegde et al, 2019; Su et al, 2020; Grigoriadis et al, 2021; Montero et al, 2021).…”

Section: Resultsmentioning

confidence: 99%

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Can periodontal measures assist in the identification of adults with undiagnosed hyperglycaemia? A systematic review

Talakey

Hughes

Bernabé

2022

J Clinic Periodontology

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Aim: The aim of this review was to answer the following question: Can periodontal measures be used to identify dental patients with undiagnosed hyperglycaemia? Materials and Methods: Systematic searches of electronic databases and the grey literature were carried out to identify studies developing and/or validating prediction models, based on any periodontal measure, to screen adults for undiagnosed hyperglycaemia (pre-diabetes and diabetes). Risk of bias was evaluated using the PRediction mOdel risk-of-Bias ASsessment Tool (PROBAST).Results: Ten studies were identified, of which eight were model development studies.The remaining two studies reported the external validation of one existing prediction model. The periodontal prediction model with some evidence of external validation showed moderate diagnostic performance in the development sample but lower performance in the external validation samples. According to PROBAST, all studies had high risk of bias mainly due to methodological limitations in data analysis, but also in the recruitment of participants, choice and measurement of periodontal predictors and diabetes.Conclusions: There is a need for more robust external validation studies of existing prediction models adhering to current recommendations. Dental professionals who see patients at risk of diabetes and routinely collect periodontal measures have an important role to play in their identification and referral.

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Periodontal Disease as a Predictor of Undiagnosed Diabetes or Prediabetes in Dental Patients

Cited by 14 publications

References 37 publications

Periodontal Diseases and COVID-19: A Scoping Review

Periodontal Diseases and COVID-19: A Scoping Review

US adults with diabetes mellitus: Variability in oral healthcare utilization

Can periodontal measures assist in the identification of adults with undiagnosed hyperglycaemia? A systematic review

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