Periodontal Health Status In Relation To Glycaemic Profile Among Type 2 Diabetic Patients At Kenyatta National Hospital

Abstract

Background Periodontal health is influenced by risk factors such as genetics, poor oral hygiene, virulence of the attacking micro-organisms and underlying systemic factors. Among the systemic factors that may influence periodontal health, is diabetes mellitus. Diabetes complications like hyperglycaemia have been known to influence periodontium through delayed wound healing, leading to higher prevalence and more severe form of periodontal disease. Main Objective To describe the periodontal health status in relation to glycaemic profiles among type 2 diabetic patients at Kenyatta National Hospital (KNH). Study area The study was conducted at the diabetic clinic at KNH. Study population All patients with type 2 diabetes presenting for treatment at the KNH diabetic clinic during the period of study were included. Sampling method This was done through a convenient sampling procedure, where only those patients examined and found to have periodontal disease were included in the study. Study design This was a hospital based descriptive cross-sectional study. Materials and Methods Sixty two patients met the inclusion criteria; ten of these did not consent to blood withdrawal and two of the samples haemolysed during transport. Data on demographical variables were:. collected and recorded in a special chart. Plaque score, clinical attachment loss, probing depth and bleeding on probing were assessed and recorded using a Hu Freidy sterile periodontal probe and dental mirrors. Probing depth was determined at six points on each tooth (mesiobuccal, buccal, distobuccal, lingual, mesiolingual, distolingual) on all teeth except the third molars. These measurements were recorded in the clinical examination form. Patients' blood samples were drawn under aseptic conditions and then taken to The Nairobi Hospital laboratory where under aseptic technique glycated haemoglobin was assessed. Data analysis and presentation Data were coded and processed with Statistical Package for Social Sciences (SPSS) 21.0. Comparison of means and proportions was done using Pearson's correlation test and Chi-Square test. Data is presented in the form of tables and chart diagrams. Results Of the SOparticipants recruited, 21(42%) were male and 29(S8%) female. Their age range was between 33 and 78 years with a mean of S6.4years (S.D ±11.27years). 47(94%) of the participants had never smoked while 3(6%) were smokers. Most 40(80%) of the participants had poor oral hygiene with mean plaque scores ~2. The overall mean plaque score was 2.S(±0.88SD). The overall mean gingival index was 1.6{±0.9SSD). Majority 37{74%) of the participants had moderate to severe gingivitis. Most 33{66%) of the participants had moderate to severe periodontitis. Most 33(66%) of the participants had poorly controlled diabetes with HbA 1c levels above 8%. There was no relationship between HbA 1c levels and the severity of periodontal disease (r=O.OO,n=SO, p>O.OS). Conclusions Majority (64%) of the participants had moderate to severe periodontitis. Majority 33(66%) of the participants had HbA 1c level of above 8%. There was no correlation between periodontal disease and HbA 1c levels. Recommendations Dental education should be carried out regularly among diabetics to ensure there is change of attitude, so that they can be going for regular dental checkups.