title: Periodontal disease in Hispanic Americans with type 2 diabetes.
abstract: BACKGROUND
  Diabetes is a major risk factor for the development of periodontal disease in certain populations. The prevalence of type 2 diabetes is increased in Hispanic Americans, but its impact on the extent and severity of periodontal disease in this population has not been determined.
  
  
  METHODS
  Sixty-three Hispanic Americans, aged 33 to 72 years, from South Texas were grouped based on the presence or absence of type 2 diabetes. Past medical histories, including smoking, were obtained. Periodontal status was evaluated by measuring probing depth (PD), clinical attachment level (CAL), plaque, bleeding on probing, visual gingival inflammation, and calculus.
  
  
  RESULTS
  Type 2 diabetes was associated frequently with major medical complications in this population. Diabetes was associated with significantly more calculus formation and tooth loss and an increased extent and severity of periodontitis. Subjects with diabetes had nearly three times the mean CAL and frequency of PD >6 mm than subjects without diabetes and nearly twice the frequency of moderate to advanced attachment loss (> or =3 mm). Smoking and diabetes had significant independent effects on mean CAL and the frequency of deep pockets. Diabetes and smoking combined were associated with a significantly higher frequency of sites with CAL > or =3 mm compared to healthy non-smokers, healthy smokers, and non-smokers with diabetes.
  
  
  CONCLUSIONS
  Hispanic Americans with type 2 diabetes had more supra- and subgingival calculus, an increased extent and severity of periodontal destruction, and an increased frequency of tooth loss due to periodontitis. An additive/synergistic contribution of type 2 diabetes and smoking for increasing the extent of periodontal disease was observed.
authors.affiliation: Center for Oral Health Research, University of Kentucky, Lexington, KY, USA. mjnova2@uky.edu
authors.forename: M John
authors.initials: MJ
authors.lastname: Novak
authors.forename: Richard M
authors.initials: RM
authors.lastname: Potter
authors.forename: Janet
authors.initials: J
authors.lastname: Blodgett
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Ebersole
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003728:Dental Calculus / Q000453:epidemiology; D003773:Dental Plaque / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D005884:Gingival Hemorrhage / Q000453:epidemiology; D005891:Gingivitis / Q000453:epidemiology; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000453:epidemiology; D010510:Periodontal Diseases / Q000453:epidemiology*; D010514:Periodontal Pocket / Q000453:epidemiology; D010518:Periodontitis / Q000453:epidemiology; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology; D013781:Texas / Q000453:epidemiology; D016388:Tooth Loss / Q000453:epidemiology