Oral Health and Diabetes : Studies on health and oral self-care in subjects with type 2 diabetes

Abstract: Oral manifestations have been reported as risk factors for diabetes mellitus, but diabetes has also attracted the attention as part of the influence on oral disease. The aims of this thesis were to evaluate several aspects of oral health among type 2 diabetic subjects in relation to various diabetes-related variables and to health-related quality of life (HRQL). The research population consisted of 102 type 2 diabetic subjects and 102 age-and-gender-matched controls without diabetes. Cross-sectional data were collected in clinical and X-ray oral examinations, from patient’s medical records, by questionnaires and from foot examinations. In some oral conditions, subjects with type 2 diabetes exhibited poorer oral health than controls. They were found to have more teeth with initial carious lesions, more advanced periodontitis, a higher prevalence of oral dryness, and a more comprehensive need for oral prevention and treatments. However, there were no significant differences in the number of natural or intact teeth, or in changes in the oral mucosa. A long diabetes duration and insulin treatment implied more teeth with manifest carious lesions, and subjects with hypertension reported more oral dryness than those who were normotensive. The hypothesis that type 2 diabetic subjects with oral dryness were affected by peripheral neuropathy could not be verified. Most type 2 diabetic subjects had never received information on, nor did they believe that there was any relationship between, oral health and diabetes. Some oral conditions contributed to a deterioration of diabetic subjects’ HRQL, even if only partly understanding of its relation to oral health could be demonstrated. Support of and close collaboration between the patient, primary health care and oral health professionals constitute a great challenge and can be a way to improve diabetic patients’ general and oral health.