Sains Malaysiana 43(8)(2014): 1157–1163

Periodontal Status and Oral Health Knowledge among a Selected Population of

Malaysian Type 2 Diabetics

(Status Periodontal dan Kesedaran Kesihatan Mulut dalam Kalangan Sekumpulan Penduduk Malaysia yang Menghidap Penyakit Diabetes Jenis 2)

MASTURA M. NORDIN, SYAKIRAH A. RAHMAN, RENUKANTH P.C. RAMAN & RATHNA D. VAITHILINGAM*

Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya

50603 Kuala Lumpur, Malaysia

Diserahkan: 8 Mac 2013/Diterima: 17 Oktober 2013

ABSTRACT

Diabetes is an important risk factor in the pathogenesis of periodontal disease. Subjects with diabetes have a greater prevalence and severity of periodontal disease compared with subjects without diabetes. This study was carried out to assess periodontal status, treatment needs and oral health awareness among a selected population of Malaysian Type 2 diabetics. Ninety four Type 2 diabetes subjects were divided into those diagnosed with periodontal disease (PD+) (CPITN≥3) and healthy/gingivitis (PD-) (CPITN≤2) groups based on the Community Periodontal Index of Treatment Needs (CPITN). Subjects were interviewed regarding socio-demographic data and oral health awareness. Their medical information was obtained from the medical records. The results showed that 55.3% subjects had (PD+) as compared with 44.7% (PD-) subjects. 18.1% subjects required advanced periodontal treatment with specialist referrals. Male diabetic subjects were more likely to have advanced periodontal disease compared to female subjects (p<0.05). Subjects with advanced periodontal disease were more likely to be on combination of insulin and oral drugs (p<0.05). (PD+) diabetic subjects were aware that they had mobile teeth (p<0.001) and gum disease (p=0.004). In conclusion, male diabetics in Malaysia and subjects on combination of insulin and oral diabetic drugs are more likely to require advanced periodontal treatment.

Keywords: CPITN; oral health awareness; periodontal disease; periodontal treatment needs; Type 2 diabetes

ABSTRAK

Penyakit diabetes adalah satu faktor risiko yang penting dalam patogenesis penyakit periodontal. Subjek dengan diabetes mempunyai kelaziman dan keterukan penyakit periodontal yang lebih berbanding dengan subjek tanpa penyakit diabetes. Kajian ini dijalankan untuk menilai status periodontal, keperluan rawatan periodontal dan kesedaran kesihatan mulut dalam kalangan sekumpulan penduduk Malaysia yang menghidap penyakit diabetes Jenis 2. Sembilan puluh empat subjek diabetes Jenis 2 telah dibahagikan kepada mereka yang didiagnosis dengan penyakit periodontal (PD +) (CPITN ≥ 3) dan gusi sihat/gingivitis (PD-) (CPITN ≤ 2) berdasarkan Indeks Komuniti Periodontal dan Keperluan Rawatan (CPITN). Subjek telah ditemu bual mengenai data sosio-demografik dan kesedaran kesihatan mulut. Maklumat perubatan mereka telah diperoleh daripada rekod perubatan. Hasil kajian menunjukkan bahawa 55.3% responden mempunyai (PD+) berbanding 44.7% (PD-). 18.1% subjek memerlukan rawatan periodontal lanjutan dengan rujukan pakar. Subjek diabetes lelaki lebih berkemungkinan untuk mempunyai penyakit periodontal lanjutan berbanding subjek perempuan (p<0.05). Subjek dengan penyakit periodontal lanjutan adalah lebih cenderung untuk mengambil gabungan ubatan insulin dan ubat-ubatan oral (p<0.05). Subjek diabetes (PD +) sedar bahawa mereka mempunyai gigi goyah (p<0.001) dan penyakit gusi (p=0.004). Kesimpulannya, subjek diabetes lelaki di Malaysia dan subjek yang mengambil gabungan insulin dan ubat-ubatan diabetes oral adalah lebih cenderung untuk mendapatkan rawatan periodontal lanjut.

Kata kunci: CPITN; diabetes Jenis 2; keperluan rawatan periodontal; kesedaran kesihatan mulut; penyakit periodontal

RUJUKAN

Albandar, J.M. 2002. Global risk factors and risk indicators for periodontal diseases. Periodontol 2000 29: 177-206.

American Diabetes Association. 2007. Standards of medical care in diabetes. Diabetes Care 30: S4-S41.

Bakhshandeh, S., Murtomaa, H., Mofid, R., Vehkalahti, M.M. & Suomalainen, K. 2007. Periodontal treatment needs of diabetic adults. J. Clin. Periodontol. 34: 53-57.

Christensen, L.B., Petersen, P.E., Krustrup, U. & Kjoller, M. 2003. Self-reported oral hygiene practices among adults in Denmark. Community Dent. Health 20: 229-235.

Cockram, C.S. 2000. The epidemiology of diabetes mellitus in the Asia-Pacific region. Hong Kong Med. J. 6: 43-52.

Dunlop, D.D., Manheim, L.M., Song, J. & Chang, R.W. 2002. Gender and ethnic/ racial disparities in health care utilization among older adults. J. Gerontol. B. Psychol. Sci. Soc. Sci. 57: S221-S233.

Emrich, L.J., Shlossman, M. & Genco, R.J. 1991. Periodontal disease in non-insulin-dependent diabetes mellitus. J. Periodontol. 62: 123-131.

Hugoson, A., Thorstensson, H., Falk, H. & Kuylenstierna, J. 1989. Periodontal conditions in insulin-dependent diabetics. J. Clin. Periodontol. 16: 215-223.

Iwamoto, Y., Nishimura, F., Nakagawa, M., Sugimoto, H., Shikata, K., Makino, H., Fukuda, T., Tsuji, T., Iwamoto, M. & Murayama, Y. 2001. The effect of antimicrobial periodontal treatment on circulating tumour necrosis factor α and glycated hemoglobin level in patients with T2D. J. Periodontol. 72: 774-778.

Jansson, H., Lindholm, E., Lindh, C., Groop, L. & Bratthall, G. 2006. Type 2 diabetes and risk for periodontal disease: A role for dental health awareness. J. Clin. Periodontol. 33: 408-414.

Karikoski, A., Hanne-Parikka, P. & Murtomaa, H. 2002. Assessment of periodontal treatment needs among adults with diabetes in Finland. Int. Dent. J. 52: 390-395.

Kinane, D.F. & Chestnutt, I.G. 1997. Relationship of diabetes to periodontitis. Curr. Opin. Periodontol. 4: 29-34.

Loe, H. 1993. Periodontal disease: The sixth complication of diabetes mellitus. Diabetes Care 16(suppl 1): 329-334.

Malaysian National Health & Morbidity Survey. 2006. Kuala Lumpur, Malaysia: (Ministry of Health Malaysia 2006)

Moore, P.A., Orchard, T., Guggenheimer, J. & Weyant, R.J. 2000. Diabetes and oral health promotion: A survey of disease prevention behaviors. J. Am. Dent. Assoc. 131: 1333-1341.

Ministry of Health Malaysia. 2001. Oral health status, impacts and treatment needs of Malaysian adults. Govt Printers, Kuala Lumpur, Malaysia.

Paulender, J., Axelsson, P., Lindhe, J. & Wennstrom, J. 2004. Some characteristics of 50/55 year old individuals with various experience of destructive periodontal disease: A cross sectional study. Acta Odontol. Scan 62: 199-206.

Petersen, P.E. & Ogawa, H. 2005. Strengthening the prevention of periodontal disease: The WHO approach. J. Periodontol. 76: 2187-2193.

Pilot, T. & Barmes, D.E. 1987. An update on periodontal conditions in adults, measures by CPITN. Int. Dent. J. 37: 169-172.

Scheen, A.J., Castillo, M.J. & Lefebvre, P.J. 1993. Combination of oral antidiabetic drugs and insulin in the treatment of non-insulin dependent diabetes. Acta Clin. Belg. 48(4): 259-268.

Sheiham. 1991. A public health aspects of periodontal diseases in Europe. J. Clin. Periodontol. 18: 362-369.

Soskolne, W.A. & Klinger, A. 2001. The relationship between periodontal diseases and diabetes: An overview. Ann Periodontol. 6: 91-98.

Taylor, G.W. 2001. Bidirectional interrelationships between diabetes and periodontal diseases: An epidemiologic perspective. Ann. Periodontol. 6: 99-112.

Taylor, G.W., Burt, B.A., Becker, M.P., Genco, R.J., Shlossman, M., Knowler, W.C. & Pettitt, D.J. 1998. Glycemic control & alv bone loss progression in type 2 diabetes. Ann. Periodontol. 3: 30-39.

Thorstensson, H., Kuylenstierna, J. & Hugoson, A. 1996. Medical status and complications in relation to periodontal disease experience in insulin-dependent diabetics. J. Clin. Periodontol. 23: 194-202.

World Health Organization (WHO) Study Group. 1994. Prevention of Diabetes. Technical Report Series. Geneva. 844: 14-17.

*Pengarang untuk surat-menyurat; email: rathna@um.edu.my