title: Association between type 1 diabetes and periodontal health.
abstract: OBJECTIVE
  We assessed periodontal status in patients with type 1 diabetes and healthy individuals in relation to their glycemic control, smoking and inflammatory biomarkers.
  
  
  METHODS
  Periodontal status was examined in 107 patients with diabetes and 40 controls, using Oral Hygiene Index (OHI), Community Periodontal Index (CPI) and tooth number. CPI values of 0-2 and 3-4 were classified as non-periodontitis and periodontitis, respectively. Blood samples were analyzed for glucose, HbA1c, CRP, fibrinogen, interleukin-1 and tumor necrosis factor-alpha (TNF-α).
  
  
  RESULTS
  Periodontitis was found in 15.0% of the controls and 57.9% of diabetic patients, including 40.0% of these with good metabolic control (GMC) and 59.5% of those with poor metabolic control (PMC). Severe periodontitis was more frequent in the PMC than in the GMC group and in the controls (26.0% vs. 20.0% vs. 5.0%). The PMC patients had lower number of sextants with CPI 0 and higher number of sextants with CPI 3 and CPI 4 as well as lower tooth number in comparison with the controls. The patients with periodontitis had higher TNF-α (p<0.001) and OHI (p<0.001) than the patients without periodontitis. The number of sextants with CPI 0 correlated negatively with fibrinogen and TNF-α levels, whereas the number of sextants with CPI 3 correlated positively with TNF-α and fasting glucose level.
  
  
  CONCLUSIONS
  There is good evidence that type 1 diabetes increases the risk of periodontal disease. Our results suggest that poor metabolic control of diabetes together with smoking and inadequate oral hygiene increase the risk of severe periodontal destruction in patients with type 1 diabetes.
authors.affiliation: Department of Endocrinology, Diabetology and Internal Diseases, Medical University of Bialystok, Bialystok, Poland. Electronic address: annapoplawskakita@op.pl.
authors.forename: Anna
authors.initials: A
authors.lastname: Popławska-Kita
authors.affiliation: Department of Endocrinology, Diabetology and Internal Diseases, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Siewko
authors.affiliation: Department of Endocrinology, Diabetology and Internal Diseases, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Szpak
authors.affiliation: Department of Restorative Dentistry, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Król
authors.affiliation: Department of Endocrinology, Diabetology and Internal Diseases, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Telejko
authors.affiliation: Department of Rheumatology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Piotr Adrian
authors.initials: PA
authors.lastname: Klimiuk
authors.affiliation: Department of Restorative Dentistry, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Wanda
authors.initials: W
authors.lastname: Stokowska
authors.affiliation: Department of Endocrinology, Diabetology and Internal Diseases, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Maria
authors.initials: M
authors.lastname: Górska
authors.affiliation: Department of Endocrinology, Diabetology and Internal Diseases, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Szelachowska
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D009910:Oral Hygiene; D010510:Periodontal Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D011379:Prognosis; D012907:Smoking / Q000009:adverse effects
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators
keywords: Cytokines; Diabetes; Hyperglycemia; Periodontitis