23 May 2023

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High prevalence of periodontitis in children and adolescents with type 2 diabetes

By Arianna Bianchi

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Early diagnosis of periodontal disease is essential to avoid tooth loss which can compromise the patient's quality of life as it reduces functional masticatory capacity, self-esteem and social relationships.

An increased risk of periodontitis has also been described in the literature in children with diabetes as early as six years of age. Unfortunately, data on children and adolescents with type 2 diabetes are limited because most study samples predominantly include individuals with type 1 diabetes.

However, some studies in the literature have instead reported a more common periodontal damage in young people with type 2 diabetes compared to those with type 1 diabetes (55 vs 29%).

Materials and methods

In a cross-sectional study, published online in the Journal of Periodontology in August 2022, the authors determined the prevalence of periodontitis in children and adolescents with type 2 diabetes and sought to establish whether poor glycemic control is associated with increased prevalence of periodontitis. 

A questionnaire about oral health care history and oral health maintenance habits was submitted to each participant; all also underwent an oral examination of the mouth.

Furthermore, the clinical and metabolic parameters were extrapolated from the medical records.

Results

One hundred twenty-one children and adolescents (8-17 years) were included in this study. Overall, 45.5% had some degree of periodontitis, 10 children/adolescents (8.3%) mild, 36 (29.8%) moderate and 9 (7.4%) severe.

The periodontitis group (PD group) showed higher mean gingival and plaque indices, periodontal probing depths, and clinical attachment loss than the group without periodontitis (NoPD group) (p < 0.05).

A statistically significant relationship was found between the prevalence of periodontitis and glycosylated hemoglobin (HbA1c) values by bivariate analysis (odds ratio [OR] 1.31 [95% CI, 1.13-1.53], p = 0.001) and multivariate (OR, 1.29 [95% CI, 1.03-1.61], p = 0.03).

For adjustment variables, associations were found for diabetes duration, age, body mass index, insulin intake, and presence of acanthosis nigricans.

Conclusions

Researchers concluded that children and adolescents with type 2 diabetes presented high rates of periodontitis comparable with that seen in previous studies in youth with diabetes. Uncontrolled HbA1c influences prevalence of periodontal disease. The lack of matched control group and radiographs are limitations of the study. Comprehensive periodontal examination is essential for children and adolescents with type 2 diabetes to prevent, identify, and treat periodontitis early.