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Periodontal disease in pregnancy complicated by type 1 diabetes mellitus
Journal article   Peer reviewed

Periodontal disease in pregnancy complicated by type 1 diabetes mellitus

Janet M. Guthmiller, Jeanne R. Hassebroek-Johnson, Duane R. Weenig, Georgia K. Johnson, H. Lester Kirchner, Frank J. Kohout and Stephen K. Hunter
Journal of periodontology, Vol.72(11), pp.1485-1490
11/01/2001
DOI: 10.1902/jop.2001.72.11.1485
PMID: 11759859

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Abstract

<p>BACKGROUND: Systemic disease and hormonal changes have been implicated as complicating factors for periodontal disease. Diabetes has been identified as a risk factor for periodontal disease, and diabetics can experience periodontal destruction at an earlier age than non-diabetic individuals. Increased hormone levels during pregnancy can contribute to increased gingival inflammation. The purpose of this study was to examine the association of type 1 diabetes mellitus (DM) on the periodontal status of pregnant women. METHODS: Thirty-three (13 diabetic and 20 non-diabetic) subjects, 20 to 39 weeks gestation, participated in this study. The mean age of the diabetics and non-diabetics was 28.5 +/- 7.1 (SD) and 27.0 +/- 7.3 years, respectively. The following parameters were assessed at Ramfjord's reference teeth: plaque index (PI), gingival inflammation (GI), probing depth (PD), gingival margin (GM) location, and clinical attachment level (CAL). RESULTS: Diabetic subjects had significantly (P<0.001) higher PI (1.48 +/- 0.69) and GI (1.77 +/- 0.44) scores than non-diabetics (PI = 0.63 +/- 0.38; GI = 0.93 +/- 0.48). Mean PD for diabetics (2.95 +/- 0.69 mm) was significantly different (P<0.024) from that of non-diabetics (2.44 +/- 0.32 mm). Although mean GM location was coronal to the cemento-enamel junction (CEJ) in both groups, gingival margins were at a more apical position (P<0.001) in the diabetics (-0.20 +/- 1.24 mm) compared to non-diabetics (-1.76 +/- 0.53 mm). Mean CAL values also varied significantly (P<0.001) between diabetics (2.60 +/- 1.54 mm) and non-diabetics (0.68 +/- 0.65 mm). Significant differences were seen for GI (P<0.001), PD (P=0.005), GM location (P<0.001), and CAL (P<0.001) when assessing the effect of diabetes and controlling for plaque. When assessing the effect of plaque and controlling for diabetes, the only significant difference was GI (P=0.001). CONCLUSIONS: The results of this study demonstrate that periodontal inflammation and destruction are increased in pregnant diabetics as compared to non-diabetic pregnant patients. These findings may have implications for diabetic control and, hence, maternal and fetal outcomes in pregnant diabetic patients.</p>
 Pregnancy Obstetrics and Gynecology Adult Analysis of Variance Dental Plaque Index Diabetes Mellitus Type 1/complications Female Gingiva/pathology Gingival Recession/classification Gingivitis/classification Humans Periodontal Attachment Loss/classification Periodontal Diseases/classification/etiology Periodontal Index Periodontal Pocket/classification Pregnancy Complications Pregnancy in Diabetics Risk Factors Single-Blind Method Statistics as Topic Tooth Cervix/pathology

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