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
Identifieur interne : 007124 ( Ncbi/Merge ); précédent : 007123; suivant : 007125Standardized 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
Auteurs : Andrew S. Pumerantz [États-Unis] ; Susan M. Bissett [Royaume-Uni] ; Fanglong Dong [États-Unis] ; Cesar Ochoa [États-Unis] ; Rebecca R. Wassall [Royaume-Uni] ; Heidi Davila [États-Unis] ; Melanie Barbee [États-Unis] ; John Nguyen [États-Unis] ; Pamela Vila [États-Unis] ; Philip M. Preshaw [Royaume-Uni]Source :
- BMJ Open Diabetes Research & Care [ 2052-4897 ] ; 2017.
Abstract
To determine prevalence and factors predictive of periodontitis by using a standardized assessment model in adults with type 2 diabetes.
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.
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.
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.
Url:
DOI: 10.1136/bmjdrc-2017-000413
PubMed: 28761663
PubMed Central: 5530235
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<author><name sortKey="Davila, Heidi" sort="Davila, Heidi" uniqKey="Davila H" first="Heidi" last="Davila">Heidi Davila</name>
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,<addr-line content-type="state">California</addr-line>
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<country xml:lang="fr">États-Unis</country>
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<author><name sortKey="Barbee, Melanie" sort="Barbee, Melanie" uniqKey="Barbee M" first="Melanie" last="Barbee">Melanie Barbee</name>
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,<institution>Western University of Health Sciences</institution>
,<addr-line content-type="city">Pomona</addr-line>
,<addr-line content-type="state">California</addr-line>
,<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Nguyen, John" sort="Nguyen, John" uniqKey="Nguyen J" first="John" last="Nguyen">John Nguyen</name>
<affiliation wicri:level="1"><nlm:aff id="aff1"><institution content-type="department">Western Diabetes Institute</institution>
,<institution>Western University of Health Sciences</institution>
,<addr-line content-type="city">Pomona</addr-line>
,<addr-line content-type="state">California</addr-line>
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,<addr-line content-type="state">California</addr-line>
,<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Preshaw, Philip M" sort="Preshaw, Philip M" uniqKey="Preshaw P" first="Philip M" last="Preshaw">Philip M. Preshaw</name>
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,<addr-line content-type="city">Newcastle upon Tyne</addr-line>
,<country>UK</country>
</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff4"><institution>Institute of Cellular Medicine, Newcastle University</institution>
,<addr-line content-type="city">Newcastle upon Tyne</addr-line>
,<country>UK</country>
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<front><div type="abstract" xml:lang="en"><sec><title>Objective</title>
<p>To determine prevalence and factors predictive of periodontitis by using a standardized assessment model in adults with type 2 diabetes.</p>
</sec>
<sec><title>Research design and methods</title>
<p>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.</p>
</sec>
<sec><title>Results</title>
<p>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.</p>
</sec>
<sec><title>Conclusions</title>
<p>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.</p>
</sec>
</div>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMJ Open Diabetes Res Care</journal-id>
<journal-id journal-id-type="iso-abbrev">BMJ Open Diabetes Res Care</journal-id>
<journal-id journal-id-type="hwp">bmjdrc</journal-id>
<journal-id journal-id-type="publisher-id">bmjdrc</journal-id>
<journal-title-group><journal-title>BMJ Open Diabetes Research & Care</journal-title>
</journal-title-group>
<issn pub-type="epub">2052-4897</issn>
<publisher><publisher-name>BMJ Publishing Group</publisher-name>
<publisher-loc>BMA House, Tavistock Square, London, WC1H 9JR</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">28761663</article-id>
<article-id pub-id-type="pmc">5530235</article-id>
<article-id pub-id-type="publisher-id">bmjdrc-2017-000413</article-id>
<article-id pub-id-type="doi">10.1136/bmjdrc-2017-000413</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Clinical care/Education/Nutrition</subject>
</subj-group>
<subj-group subj-group-type="hwp-journal-coll"><subject>1506</subject>
</subj-group>
</article-categories>
<title-group><article-title>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</article-title>
</title-group>
<contrib-group><contrib id="author-38978891" contrib-type="author"><name><surname>Pumerantz</surname>
<given-names>Andrew S</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
<xref ref-type="aff" rid="aff2">2</xref>
</contrib>
<contrib id="author-54027922" contrib-type="author"><name><surname>Bissett</surname>
<given-names>Susan M</given-names>
</name>
<xref ref-type="aff" rid="aff3">3</xref>
<xref ref-type="aff" rid="aff4">4</xref>
</contrib>
<contrib id="author-54028018" contrib-type="author"><name><surname>Dong</surname>
<given-names>Fanglong</given-names>
</name>
<xref ref-type="aff" rid="aff5">5</xref>
</contrib>
<contrib id="author-54028055" contrib-type="author"><name><surname>Ochoa</surname>
<given-names>Cesar</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
<contrib id="author-54028686" contrib-type="author"><name><surname>Wassall</surname>
<given-names>Rebecca R</given-names>
</name>
<xref ref-type="aff" rid="aff3">3</xref>
</contrib>
<contrib id="author-54028111" contrib-type="author"><name><surname>Davila</surname>
<given-names>Heidi</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
<contrib id="author-54028145" contrib-type="author"><name><surname>Barbee</surname>
<given-names>Melanie</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
<contrib id="author-54028197" contrib-type="author"><name><surname>Nguyen</surname>
<given-names>John</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
<contrib id="author-54028221" contrib-type="author"><name><surname>Vila</surname>
<given-names>Pamela</given-names>
</name>
<xref ref-type="aff" rid="aff2">2</xref>
</contrib>
<contrib id="author-44226237" contrib-type="author"><name><surname>Preshaw</surname>
<given-names>Philip M</given-names>
</name>
<xref ref-type="aff" rid="aff3">3</xref>
<xref ref-type="aff" rid="aff4">4</xref>
</contrib>
</contrib-group>
<aff id="aff1"><label>1</label>
<institution content-type="department">Western Diabetes Institute</institution>
,<institution>Western University of Health Sciences</institution>
,<addr-line content-type="city">Pomona</addr-line>
,<addr-line content-type="state">California</addr-line>
,<country>USA</country>
</aff>
<aff id="aff2"><label>2</label>
<institution>College of Osteopathic Medicine of the Pacific, Western University of Health Sciences</institution>
,<addr-line content-type="city">Pomona</addr-line>
,<addr-line content-type="state">California</addr-line>
,<country>USA</country>
</aff>
<aff id="aff3"><label>3</label>
<institution>School of Dental Sciences, Centre for Oral Health Research, Newcastle University</institution>
,<addr-line content-type="city">Newcastle upon Tyne</addr-line>
,<country>UK</country>
</aff>
<aff id="aff4"><label>4</label>
<institution>Institute of Cellular Medicine, Newcastle University</institution>
,<addr-line content-type="city">Newcastle upon Tyne</addr-line>
,<country>UK</country>
</aff>
<aff id="aff5"><label>5</label>
<institution>Graduate College of Biomedical Sciences, Western University of Health Sciences</institution>
,<addr-line content-type="city">Pomona</addr-line>
,<addr-line content-type="state">California</addr-line>
,<country>USA</country>
</aff>
<author-notes><corresp><label>Correspondence to</label>
Dr Andrew S Pumerantz; <email>apumerantz@westernu.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="collection"><year>2017</year>
</pub-date>
<pub-date pub-type="epub"><day>7</day>
<month>7</month>
<year>2017</year>
</pub-date>
<volume>5</volume>
<issue>1</issue>
<elocation-id>e000413</elocation-id>
<history><date date-type="received"><day>08</day>
<month>3</month>
<year>2017</year>
</date>
<date date-type="rev-recd"><day>08</day>
<month>5</month>
<year>2017</year>
</date>
<date date-type="accepted"><day>01</day>
<month>6</month>
<year>2017</year>
</date>
</history>
<permissions><copyright-statement>© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.</copyright-statement>
<copyright-year>2017</copyright-year>
<license license-type="open-access"><license-p>This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">http://creativecommons.org/licenses/by-nc/4.0/</ext-link>
</license-p>
</license>
</permissions>
<self-uri xlink:title="pdf" xlink:href="bmjdrc-2017-000413.pdf"></self-uri>
<abstract><sec><title>Objective</title>
<p>To determine prevalence and factors predictive of periodontitis by using a standardized assessment model in adults with type 2 diabetes.</p>
</sec>
<sec><title>Research design and methods</title>
<p>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.</p>
</sec>
<sec><title>Results</title>
<p>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.</p>
</sec>
<sec><title>Conclusions</title>
<p>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.</p>
</sec>
</abstract>
<kwd-group><kwd>type 2 diabetes</kwd>
<kwd>comorbidity of chronic diseases</kwd>
<kwd>periodontal disease</kwd>
<kwd>multidisciplinary</kwd>
<kwd>screening strategies</kwd>
</kwd-group>
<funding-group specific-use="FundRef"><award-group id="funding-1"><funding-source><institution-wrap><institution>UK Department of Health</institution>
</institution-wrap>
</funding-source>
</award-group>
<award-group id="funding-2"><funding-source><institution-wrap><institution-id institution-id-type="FundRef">http://dx.doi.org/10.13039/501100000377</institution-id>
<institution>Dunhill Medical Trust</institution>
</institution-wrap>
</funding-source>
</award-group>
</funding-group>
<custom-meta-group><custom-meta><meta-name>special-feature</meta-name>
<meta-value>unlocked</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Royaume-Uni</li>
<li>États-Unis</li>
</country>
</list>
<tree><country name="États-Unis"><noRegion><name sortKey="Pumerantz, Andrew S" sort="Pumerantz, Andrew S" uniqKey="Pumerantz A" first="Andrew S" last="Pumerantz">Andrew S. Pumerantz</name>
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<name sortKey="Barbee, Melanie" sort="Barbee, Melanie" uniqKey="Barbee M" first="Melanie" last="Barbee">Melanie Barbee</name>
<name sortKey="Davila, Heidi" sort="Davila, Heidi" uniqKey="Davila H" first="Heidi" last="Davila">Heidi Davila</name>
<name sortKey="Dong, Fanglong" sort="Dong, Fanglong" uniqKey="Dong F" first="Fanglong" last="Dong">Fanglong Dong</name>
<name sortKey="Nguyen, John" sort="Nguyen, John" uniqKey="Nguyen J" first="John" last="Nguyen">John Nguyen</name>
<name sortKey="Ochoa, Cesar" sort="Ochoa, Cesar" uniqKey="Ochoa C" first="Cesar" last="Ochoa">Cesar Ochoa</name>
<name sortKey="Pumerantz, Andrew S" sort="Pumerantz, Andrew S" uniqKey="Pumerantz A" first="Andrew S" last="Pumerantz">Andrew S. Pumerantz</name>
<name sortKey="Vila, Pamela" sort="Vila, Pamela" uniqKey="Vila P" first="Pamela" last="Vila">Pamela Vila</name>
</country>
<country name="Royaume-Uni"><noRegion><name sortKey="Bissett, Susan M" sort="Bissett, Susan M" uniqKey="Bissett S" first="Susan M" last="Bissett">Susan M. Bissett</name>
</noRegion>
<name sortKey="Bissett, Susan M" sort="Bissett, Susan M" uniqKey="Bissett S" first="Susan M" last="Bissett">Susan M. Bissett</name>
<name sortKey="Preshaw, Philip M" sort="Preshaw, Philip M" uniqKey="Preshaw P" first="Philip M" last="Preshaw">Philip M. Preshaw</name>
<name sortKey="Preshaw, Philip M" sort="Preshaw, Philip M" uniqKey="Preshaw P" first="Philip M" last="Preshaw">Philip M. Preshaw</name>
<name sortKey="Wassall, Rebecca R" sort="Wassall, Rebecca R" uniqKey="Wassall R" first="Rebecca R" last="Wassall">Rebecca R. Wassall</name>
</country>
</tree>
</affiliations>
</record>
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