Condition of Periodontal Tissues and the Degree of Diabetes Control Expressed by the Level of Glycated Hemoglobin HbA1c

Background. Periodontal diseases are chronic inflammatory processes in the tooth surrounding tissues. Apart from the oral microflora, stress, and smoking, the risk factors for periodontal diseases include also diabetes. There is a well-known number of relationships between the periodontal disease and diabetes. The presence of chronic periodontitis in patients with diabetes makes it difficult to regulate glucose levels and diabetes as a metabolic disorder affects the intensity of destructive processes in periodontal tissues. Objectives. The assessment of periodontal tissues' condition, depending on the degree of diabetes control defined by glycated hemoglobin values in patients with diabetes. Material and Methods. The study included 155 patients treated at the Central Clinical Hospital of Ministry of Interior Affairs due to type 2 diabetes. The study protocol, preparated in according with the Declaration of Helsinki of 1973, was approved by the responsible Ethics Committee. In all patients following measurements were performed: level of glycated hemoglobin in blood and periodontal examination including depth of periodontal pockets (PD), loss of connective tissue attachment (CAL), aproximal plaque index (API) and bleeding index (BOP). Patients were classified on the basis of periodontal status using a new scale by Offenbacher. Results. Based on the survey scale by Offenbacher, in 14 patients the absence of an inflammation in periodontal tissues (BGI-H), in 119 BGI-G-gingivitis, in 22 P2 - moderate periodontitis was found. A significant correlation between the level of the glycated hemoglobin and the average depth of periodontal pockets was observed. It has been shown that the more advanced periodontal disease was, the higher levels of glycated hemoglobin patients were observed. In patients with higher levels of glycated hemoglobin the higher bleeding index and greater loss of connective tissue attachment was observed. Conclusions. Basing on the survey it is hard to establish causal relationship between diabetes and periodontitis, but the results suggest that untreated or poorly managed periodontal disease worsens glycemic control