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Standardized screening for periodontitis as an integral part of multidisciplinary management of adults with type 2 diabetes: An observational cross-sectional study of cohorts in the USA and UK

Lookup NU author(s): Dr Susan BissettORCiD, Dr Rebecca Wassall, Professor Philip Preshaw



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. Objective To determine prevalence and factors predictive of periodontitis by using a standardized assessment model in adults with type 2 diabetes. Research design and methods We performed an observational cross-sectional study to determine the burden of periodontitis in adults with type 2 diabetes attending urban, ambulatory referral centers in the USA and UK. Full-mouth probing was performed and periodontitis was diagnosed based on either a low (≥5 mm at ≥1 site) or high pocket probing-depth threshold (≥6 mm at ≥1 site). Results were stratified into a five-stage schema and integrated with other clinical variables into the novel Diabetes Cross-Disciplinary Index to function as a balanced health scorecard. Corresponding demographic and routinely collected health data were obtained and comparisons were made between patients with and without periodontitis. Multivariable logistic regression was performed to identify factors predictive of the presence or absence of periodontitis. Results Between our two cohorts, 253 patients were screened. Caucasians comprised >90% and Hispanic Americans >75% of the UK and US cohorts, respectively. Males and females were equally distributed; mean age was 53.6±11 years; and 17 (6.7%) were edentulous. Of the 236 dentate patients, 128 (54.2%) had periodontitis by low threshold and 57 (24.2%) by high threshold. Just 17 (7.2%) were periodontally healthy. No significant differences in age, HbA1c, blood pressure, body mass index, low-density lipoprotein cholesterol, or smoking status (all p>0.05) were identified between those with or without periodontitis (regardless of threshold) and none was found to be a significant predictor of disease. Conclusions Periodontitis is frequent in adults with type 2 diabetes and all should be screened. Periodontal health status can be visualized with other comorbidities and complications using a novel balanced scorecard that could facilitate patient–clinician communication, shared decision-making, and prioritization of individual healthcare needs.

Publication metadata

Author(s): Pumerantz AS, Bissett SM, Dong F, Ochoa C, Wassall RR, Davila H, Barbee M, Nguyen J, Vila P, Preshaw PM

Publication type: Article

Publication status: Published

Journal: BMJ Open Diabetes Research and Care

Year: 2017

Volume: 5

Issue: 1

Print publication date: 01/07/2017

Online publication date: 07/07/2017

Acceptance date: 01/06/2017

Date deposited: 26/07/2017

ISSN (electronic): 2052-4897

Publisher: BMJ Publishing Group


DOI: 10.1136/bmjdrc-2017-000413


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