Impact of diabetes mellitus on periapical, periodontal, and oral health and the potential confounders: A cross-sectional study.

OBJECTIVE

This study aims to assess the impact of diabetes mellitus (DM) on DMFT, periodontal, and periapical conditions, and to analyze potentially significant confounders, including sociodemographic and lifestyle factors.

METHODS

A cross-sectional study was conducted in July 2021 involving patients aged ≥20 years, with available panoramic radiographs and documented DM status. Sociodemographic factors, lifestyle behaviors (alcohol consumption, betel quid chewing, and smoking), oral health indicators (decayed, missing, and filled teeth [DMFT] index, periodontal and periapical conditions), and DM status were collected. Associations between DM, lifestyle behaviors, and oral health indicators were analyzed using independent sample t-test and chi-square tests. Analysis of covariance and sensitivity analysis were conducted using adjusted models, and stepwise multiple linear regression identified the most significant predictors.

RESULTS

A total of 520 patients were included. Patients with DM had a significantly higher DMFT index (p < 0.01), a 2.97 times greater risk (p < 0.01) of developing periodontal disease, and a 1.76 times greater risk (p = 0.04) of having apical periodontitis compared to those without DM. After age adjustment, females had higher filled teeth (FT) (p < 0.01) and DMFT index (p < 0.05), while patients with DM and smokers had fewer FT (p < 0.05). Age, gender, and lifestyle behaviors were identified as confounders impacting the association with DM. Stepwise regression revealed age as the most significant predictor of the DMFT index (R²=0.35; F = 183; p < 0.01).

CONCLUSION

DM affects oral health by increasing the DMFT index and the risk of periodontal disease and apical periodontitis, with age, gender, and lifestyle habits as confounders.

CLINICAL SIGNIFICANCE: Periodontitis, apical periodontitis, oral health status, and demographic and lifestyle factors show a strong association with DM.