Assessment of periodontal conditions and systemic disease in older subjects.
BACKGROUND
An increased risk for periodontitis has been associated both with type-1 or insulin dependent diabetes (IDDM) and with type-2 or non-insulin dependent diabetes (NIDDM).


OBJECTIVE
1) To describe and analyze periodontal conditions in older low-income ethnic diverse subjects with or without a diagnosis of diabetes. 2) To assess to what extent diabetes mellitus is associated with periodontal status, and 3) how periodontitis ranks as a coexisting disease among other diseases in subjects with diabetes mellitus.


METHODS
Radiographic signs of alveolar bone loss were studied in 1101 older subjects 60-75 years old (mean age 67.6, SD+/-4.7). The number of periodontal sites and the proportions of teeth with probing depth (PD) > or =5 mm, clinical attachment levels (CAL) > or =4 mm were studied in a subset of 701 of the subjects.


RESULTS
IDDM was reported by 2.9% and NIDDM by 9.2% of the subjects. The number of remaining teeth did not differ by diabetic status. The number of sites with PD > or =5 mm and the proportion of PD with > or =5 mm was significantly smaller in the non-diabetic group (chi2=46.8, p<0.01, and chi2=171.1, p<0.001, respectively). Statistical analysis failed to demonstrate group differences for the number and proportions of sites with CAL > or =4 mm and for radiographic findings of alveolar bone loss. Combining all periodontal parameters revealed that the Mantel-Haenszel common odds of having IDDM/NIDDM and periodontitis was 1.8 : 1 (95% CI: 1.1-3.1, p<0.03). The common odds ratio estimate of an association between heart disease and diabetes was 3.6 : 1 (95% CI: 2.1-2.6, p<0.001).


CONCLUSIONS
Probing depth differences between IDDM/NIDDM vs. non-diabetic subjects may reflect the presences of pseudo-pockets and not progressive periodontitis in many subjects with diabetes mellitus. Periodontitis is not a predominant coexisting disease in older subjects with diabetes mellitus.
Persson
R E
RE
Departments of Oral Medicine, University of Washington, Seattle, WA 98195-7444, USA. rper@u.washington.edu
Hollender
L G
LG
MacEntee
M I
MI
Wyatt
C C L
CC
Kiyak
H A
HA
Persson
G R
GR
D000367:Age Factors; D000368:Aged; D016301:Alveolar Bone Loss / Q000145:classification / Q000150:complications; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D048909:Diabetes Complications; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005006:Ethnicity; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000150:complications; D008875:Middle Aged; D016017:Odds Ratio; D017622:Periodontal Attachment Loss / Q000145:classification / Q000150:complications; D010510:Periodontal Diseases / Q000150:complications*; D010514:Periodontal Pocket / Q000145:classification / Q000150:complications; D010518:Periodontitis / Q000145:classification / Q000150:complications; D011203:Poverty; D012307:Risk Factors; D018709:Statistics, Nonparametric