Sylvia Todescan DDS, MSc, PhD, FRCDC (C) is an Associate Professor for the Division of Periodontics and a Periodontics Predoctoral Director at the Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
Dr. Todescan recently did a podcast with the AAP regarding her latest research study about diabetes in children and adolescents. Her initial interest on the topic was sparked when she watched a presentation from Dr. Elizabeth Sellers about the higher incidence of type-2 diabetes in children and adolescents from Manitoba compared to the rest of Canada.
She informs that the literature lacks larger studies involving children and adolescents with type-2 diabetes, with most studies reporting larger samples with type-1 diabetes. Diabetes is a well-known risk factor for periodontal disease in adults, but the literature also reports a higher prevalence in children and adolescents presenting attachment loss as early as age 6. The objective of the study was to determine the prevalence of periodontitis in children and adolescents with type-2 diabetes and to see if more glycemic control is associated with increasing prevalence of the disease.
Dr. Todescan and her team did a cross-sectional study involving 121 children and adolescents with type-2 diabetes from ages 8-17 years and 11 months. Dr. Todescan applied herself and made strong efforts to gather data for the study, which included administering the questionnaire, including oral healthcare history, oral health behaviors, and evaluation of full-mouth periodontal parameters recorded on six sites per tooth. This involved plaque and gingival indexes, periodontal probing depth, and gingival margin location to calculate clinical attachment loss following Centers for Disease Control and Prevention (CDC) and the American Academy of Periodontology (AAP) protocol. Statistical analysis was performed using R statistical software (version 3.4.4). The PPD and AL in relation to periodontitis prevalence and severity was calculated, respectively, using Mann‒Whitney and Kruskal‒Wallis tests. Bivariate and adjusted multivariate logistic regression were used.
Overall, the study found a high prevalence of periodontitis in children and adolescents with type-2 diabetes. Dr. Todescan and her team found “several potentially modifiable risk factors including poor glycemic control, lack of access to basic sanitary needs, poor daily dental self-care, and cigarette smoking.” Additionally, they concluded that “The standard of care for this population should include regular full-mouth periodontal examinations to detect and treat premature signs of attachment loss to control disease progression.”
The podcast can be accessed on the JOP podcast page or on SoundCloud.
To read more about the data collection, findings, limitations, and more, read the Journal of Periodontology (JOP) article here: https://aap.onlinelibrary.wiley.com/doi/10.1002/JPER.21-0226.