Frequency and severity of periodontitis in Australians with type 2 diabetes mellitus: Building representative epidemiological data and validation of an oral health screening tool for non-dental personnel

Abstract

BACKGROUND: The relationship between periodontitis and type 2 diabetes mellitus has been shown to be a bidirectionally interrelated one. Furthermore, literature has established that by treating periodontitis in patients with diabetes, glycaemic levels may be improved. Despite these findings, there is limited integration of oral health care into diabetes care in Australia. The epidemiological data on the prevalence of periodontitis among patients with type 2 diabetes mellitus in Australia is lacking.

AIMS: Part A aimed to investigate the interplay between diabetes and periodontitis and how the two diseases are being managed via medical and dental services. Part B aimed to provide a cross-sectional description of how oral conditions are managed by general practitioners (GPs) in Australia. Part C primarily aimed to provide a preliminary description of the prevalence of periodontitis among patients diagnosed with type 2 diabetes in Australia. The secondary aim is to develop a questionnaire as a screening tool and evaluate its validity for the prediction of periodontitis to be adopted in an integrated care pathway.

METHODS: In Part B, data from the Bettering the Evaluation and Care of Health study (2006 to 2016 inclusive) were analysed. In Part C, two questionnaires and a clinical assessment were conducted on recruited patients with type 2 diabetes. Participants' medical records and laboratory assessment records were also obtained. A descriptive data analysis was performed.

RESULTS: Part B found that oral conditions were managed at a rate of 1.19 conditions per 100 GP encounters. The most commonly reported oral conditions were dental and oral mucosa-related. Part C found a high prevalence (75%) of moderate or severe periodontitis were diagnosed among the recruited participants diagnosed with type 2 diabetes.

CONCLUSION: Part B provided an overview of management of oral conditions by GPs in Australia, which may contribute to public health discussions around optimising an integrated health care pathway. Findings from Part C may indicate a high prevalence of periodontitis among Australian patients with type 2 diabetes, however future research with a larger sample size is required to confirm such finding. These findings highlight the potential benefit of integrating screening for periodontitis and subsequent oral health management within diabetes care, as patients’ glycaemic levels may be improved from such treatment.