Management of periodontal disease in patients with diabetes- good clinical practice guidelines: A joint statement by Indian Society of Periodontology and Research Society for the Study of Diabetes in India

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Abstract

There is a huge body of literature suggesting an association and a bidirectional relationship between periodontal disease and diabetes. Diabetes and periodontal diseases are both chronic diseases with a high prevalence. Dentists/periodontists, in their daily clinical practice, very often attend to diabetes patients with diverse oral health conditions and cater to their dental treatment needs. Safe and effective periodontal therapy in this population requires a broad understanding of diabetes, medical management of diabetes, and essential modifications to dental/periodontal therapy that may be required. This paper describes a joint statement put forth by the Indian Society of Periodontology and the Research Society for the Study of Diabetes in India aiming to provide expert consensus and evidence-based guidelines for optimal clinical management of periodontal conditions in diabetes patients or patients at risk for diabetes. Although this paper is not envisioned to be a comprehensive review of this topic, it intends to provide the guidelines for dental professionals and periodontists.

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Most cited references 199

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WITHDRAWN: Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th edition

Pouya Saeedi, Inga Petersohn, Paraskevi Salpea … (2019)

To provide global estimates of diabetes prevalence for 2019 and projections for 2030 and 2045.

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Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.

Christopher J L Murray, Theo Vos, Rafael Lozano … (2013)

Measuring disease and injury burden in populations requires a composite metric that captures both premature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposed disability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burden worldwide incorporating a systematic reassessment of disease and injury-specific epidemiology has been done since the 1990 study. We aimed to calculate disease burden worldwide and for 21 regions for 1990, 2005, and 2010 with methods to enable meaningful comparisons over time. We calculated DALYs as the sum of years of life lost (YLLs) and years lived with disability (YLDs). DALYs were calculated for 291 causes, 20 age groups, both sexes, and for 187 countries, and aggregated to regional and global estimates of disease burden for three points in time with strictly comparable definitions and methods. YLLs were calculated from age-sex-country-time-specific estimates of mortality by cause, with death by standardised lost life expectancy at each age. YLDs were calculated as prevalence of 1160 disabling sequelae, by age, sex, and cause, and weighted by new disability weights for each health state. Neither YLLs nor YLDs were age-weighted or discounted. Uncertainty around cause-specific DALYs was calculated incorporating uncertainty in levels of all-cause mortality, cause-specific mortality, prevalence, and disability weights. Global DALYs remained stable from 1990 (2·503 billion) to 2010 (2·490 billion). Crude DALYs per 1000 decreased by 23% (472 per 1000 to 361 per 1000). An important shift has occurred in DALY composition with the contribution of deaths and disability among children (younger than 5 years of age) declining from 41% of global DALYs in 1990 to 25% in 2010. YLLs typically account for about half of disease burden in more developed regions (high-income Asia Pacific, western Europe, high-income North America, and Australasia), rising to over 80% of DALYs in sub-Saharan Africa. In 1990, 47% of DALYs worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43% from non-communicable diseases, and 10% from injuries. By 2010, this had shifted to 35%, 54%, and 11%, respectively. Ischaemic heart disease was the leading cause of DALYs worldwide in 2010 (up from fourth rank in 1990, increasing by 29%), followed by lower respiratory infections (top rank in 1990; 44% decline in DALYs), stroke (fifth in 1990; 19% increase), diarrhoeal diseases (second in 1990; 51% decrease), and HIV/AIDS (33rd in 1990; 351% increase). Major depressive disorder increased from 15th to 11th rank (37% increase) and road injury from 12th to 10th rank (34% increase). Substantial heterogeneity exists in rankings of leading causes of disease burden among regions. Global disease burden has continued to shift away from communicable to non-communicable diseases and from premature death to years lived with disability. In sub-Saharan Africa, however, many communicable, maternal, neonatal, and nutritional disorders remain the dominant causes of disease burden. The rising burden from mental and behavioural disorders, musculoskeletal disorders, and diabetes will impose new challenges on health systems. Regional heterogeneity highlights the importance of understanding local burden of disease and setting goals and targets for the post-2015 agenda taking such patterns into account. Because of improved definitions, methods, and data, these results for 1990 and 2010 supersede all previously published Global Burden of Disease results. Bill & Melinda Gates Foundation. Copyright © 2012 Elsevier Ltd. All rights reserved.

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Derivation and validation of a short-form oral health impact profile.

Gary D Slade (1997)

Growing recognition that quality of life is an important outcome of dental care has created a need for a range of instruments to measure oral health-related quality of life. This study aimed to derive a subset of items from the Oral Health Impact Profile (OHIP-49)-a 49-item questionnaire that measures people's perceptions of the impact of oral conditions on their well-being. Secondary analysis was conducted using data from an epidemiologic study of 1217 people aged 60+ years in South Australia. Internal reliability analysis, factor analysis and regression analysis were undertaken to derive a subset (OHIP-14) questionnaire and its validity was evaluated by assessing associations with sociodemographic and clinical oral status variables. Internal reliability of the OHIP-14 was evaluated using Cronbach's coefficient alpha. Regression analysis yielded an optimal set of 14 questions. The OHIP-14 accounted for 94% of variance in the OHIP-49; had high reliability (alpha = 0.88); contained questions from each of the seven conceptual dimensions of the OHIP-49; and had a good distribution of prevalence for individual questions. OHIP-14 scores and OHIP-49 scores displayed the same pattern of variation among sociodemographic groups of older adults. In a multivariate analysis of dentate people, eight oral status and sociodemographic variables were associated (P < 0.05) with both the OHIP-49 and the OHIP-14. While it will be important to replicate these findings in other populations, the findings suggest that the OHIP-14 has good reliability, validity and precision.

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Author and article information

Journal

Journal ID (nlm-ta): J Indian Soc Periodontol

Journal ID (iso-abbrev): J Indian Soc Periodontol

Journal ID (publisher-id): JISP

Title: Journal of Indian Society of Periodontology

Publisher: Wolters Kluwer - Medknow (India )

ISSN (Print): 0972-124X

ISSN (Electronic): 0975-1580

Publication date (Print): Nov-Dec 2020

Publication date (Electronic): 14 November 2020

Volume: 24

Issue: 6

Pages: 498-524

Affiliations

[1] Department of Periodontology, Dr. H. S. J. Institute of Dental Sciences, Panjab University, Chandigarh, India

[1 ] Lina Diabetes Care Centre, Mumbai, Maharashtra, India

[2 ] Department of Periodontology, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India

[3 ] North Delhi Diabetes Centre, Rohini, New Delhi, India

[4 ] Department of Endocrinology and Metabolism, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India

[5 ] Department of Periodontology, D. A. V. Dental College and Hospital, Yamunanagar, Haryana, India

[7] Consultant Periodontist, Dr. Grover’s Dental Clinic, New Delhi, India

[1 ] Consultant Periodontist, Renupriya Dental Health Care, Bengaluru, Karnataka, India

[2 ] Department of Periodontics, Vivekanandha Dental College for Women, Tiruchengode, Tamil Nadu, India

[3 ] Chief Diabetologist & Chairman, Diacare – Diabetes Care & Hormone Clinic, Ahmedabad, Gujarat, India

[4 ] Aegle Clinic‑Diabetes Care, Head of Department, Internal Medicine at Ruby Hall Clinic, Pune, India

[5 ] Dr. Makkar’s Diabetes and Obesity Centre, New Delhi, India

[6 ] Sunil’s Diabetes Care n’ Research Centre Pvt. Ltd., Nagpur, Maharashtra, India

[14] Department of Periodontology, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India

[1 ] Department of Periodontics, AB Shetty Memorial Institute of Dental Sciences, Nitte (Deemed to be University), Mangalore, Karnataka, India

[2 ] Department of Periodontology, Faculty of Dental Sciences, King George’s Medical University, Lucknow, Uttar Pradesh, India

[3 ] Consultant Periodontist, Kurian Dental Clinic, Villupuram, Tamil Nadu, India

[4 ] Senior Consultant Physician, Apollo Hospitals, Apollo Health City, Hyderabad, Telangana, India

[5 ] Department of Diabetology, Institute of Diabetology, Madras Medical College, Chennai, Tamil Nadu, India

[6 ] Department of General Medicine, BBD University, Lucknow, Uttar Pradesh, India

[7 ] Sun Valley Diabetes Care and Research Centre, Guwahati, Assam, India

[22] Department of Periodontology, The Oxford Dental College, Bengaluru, Karnataka, India

[1 ] Department of Periodontology and Oral Implantology, Sri Siddhartha Dental College, Tumakuru, Karnataka, India

[2 ] Department of Periodontology, Government Dental College and Hospital, Aurangabad, Maharashtra, India

[3 ] Department of Periodontology, K. M. Shah Dental College, Sumandeep Vidyapeeth, Vadodara, Gujarat, India

[4 ] Unit of Periodontics, Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India

[5 ] Central Delhi Diabetes Centre, New Delhi, India

[6 ] Department of General Medicine, Dr. B. R. Ambedkar Medical College, K. G. Halli, Bengaluru, Karnataka, India

[7 ] Consultant Diabetes Specialist, Jethwani Hospital, Rajkot, Gujarat, India

[8 ] Department of Endocrinology, Osmania Medical College, Hyderabad, Telangana, India

[31] Department of Periodontology, Mahe Institute of Dental Sciences and Hospital, Chalakkara, Mahe, Puducherry, India

[1 ] Department of Periodontology, Government Dental College and Hospital, Mumbai, Maharashtra, India

[2 ] Department of Periodontology, SRM Kattankulathur Dental College, Potheri, Kattankulathur, Tamil Nadu, India

[3 ] Department of Periodontics, SCB Government Dental College and Hospital, Mangalabag, Cuttack, Odisha, India

[4 ] Department of Periodontology and Oral Implantology, Maharishi Markandeshwar College of Dental Sciences and Research, Mullana, Haryana, India

[5 ] Department of Medicine, SMS Medical College and Hospital, Jaipur, Rajasthan, India

[6 ] Department of Endocrinology and Diabetes, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India

[7 ] Center for Diabetes and Endocrine Care, Bengaluru, Karnataka, India

[8 ] Lifecare Diabetes Centre, Kirti Nagar, New Delhi, India

[40] Consultant Periodontist, Dr. Ganorkar Hospital, Gaikwad Nagar, Nashik,Maharashtra, India

[1 ] Department of Periodontics, T. N. Government Dental College and Hospital, Chennai, Tamil Nadu, India

[2 ] Department of Periodontology, Institute of Dental Studies and Technologies, Kadrabad, Modinagar, India

[3 ] Department of Periodontology, Inderprastha Dental College and Hospital, Sahibabad, Ghaziabad, Uttar Pradesh, India

[4 ] Prof. M. Viswanathan Diabetes Research Centre, Chennai, Tamil Nadu, India

[5 ] Director, Diacon Hospital, Bengaluru, Karnataka, India

[6 ] Director of Diabetes Care & Research Centre, MGM College, Aurangabad, Maharashtra, India

[7 ] Department of Medicine, MM Dental College, Belgaum, Karnataka, India

Author notes

Address for correspondence: Dr. Ashish Jain, Department of Periodontology, Dr. H. S. J. Institute of Dental Sciences, Panjab University, Chandigarh - 160 014, India. E-mail: ashish@ 123456justice.com

The work belongs jointly to the Indian Society of Periodontology and Research Society for the Study of Diabetes in India

[*]

Member, Indian Society of Periodontology.

[#]

Member, Research Society for the Study of Diabetes in India

Article

Publisher ID: JISP-24-498

DOI: 10.4103/jisp.jisp_688_20

PMC ID: 7781257

PubMed ID: 33424167

SO-VID: d6328a55-0095-49a0-9d04-abaea628c403

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This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Management of periodontal disease in patients with diabetes- good clinical practice guidelines: A joint statement by Indian Society of Periodontology and Research Society for the Study of Diabetes in India

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Most cited references 199

WITHDRAWN: Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th edition

Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.

Derivation and validation of a short-form oral health impact profile.

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