Ayse Basak Cinar1, Inci Oktay, Lone Schou. 1. Oral Public Health Department, Institute of Odontology, University of Copenhagen, Norre Alle 20, 2200, Copenhagen, Denmark. aci@sund.ku.dk
Abstract
OBJECTIVES: The aim of this study was to assess the relationship between tooth loss, toothbrushing behaviour, diabetes type 2 (DM2), obesity and sleep apnea among diabetics. MATERIAL AND METHODS: DM2 patients (n = 165) in Istanbul, Turkey, were randomly selected from the outpatient clinics of two hospitals. Baseline clinical measurements (HbA1c, fasting blood glucose, high-density lipoprotein (HDL), low-density lipoprotein (LDL), body mass index (BMI), body-fat proportion, tooth loss) and self-administered questionnaires (toothbrushing, gingival bleeding, sleep apnea) provided data for factor and principal component analysis with Varimax rotation. Univariate statistics and chi-square tests were derived. RESULTS: Mean maxillary tooth loss (4.49 ± 3.69 teeth) was higher than in the mandible (3.43 ± 3.12 teeth, p< 0.001). Favourable HDL was measured among most patients (77%); other favourable clinical measures occurred only in a minority of participants (HbA1c, 28%; fasting blood glucose, 17%; LDL, 30%). Twice daily toothbrushing was reported by 33% (17%) for healthy BMI; 37% when healthy body-fat proportions. There was risk of sleep apnea in 37 %. The higher number of lost teeth in the maxilla was linked with obesity and sleep apnea. Non-daily toothbrushers were more likely to have high LDL and low HDL cholesterol and a higher risk of sleep apnea. When "at least occasionally" bleeding on toothbrushing occurred, higher HbA1c levels and sleep apnea were more likely. CONCLUSION: Oral care with early diagnosis and monitoring of glycaemic level can help prevent complications of DM2. CLINICAL RELEVANCE: Dentists may play a key role in better managing and diagnosing sleep apnea early by referring the patients with severe tooth loss and periodontal disease for general medical examination.
OBJECTIVES: The aim of this study was to assess the relationship between tooth loss, toothbrushing behaviour, diabetes type 2 (DM2), obesity and sleep apnea among diabetics. MATERIAL AND METHODS:DM2patients (n = 165) in Istanbul, Turkey, were randomly selected from the outpatient clinics of two hospitals. Baseline clinical measurements (HbA1c, fasting blood glucose, high-density lipoprotein (HDL), low-density lipoprotein (LDL), body mass index (BMI), body-fat proportion, tooth loss) and self-administered questionnaires (toothbrushing, gingival bleeding, sleep apnea) provided data for factor and principal component analysis with Varimax rotation. Univariate statistics and chi-square tests were derived. RESULTS: Mean maxillary tooth loss (4.49 ± 3.69 teeth) was higher than in the mandible (3.43 ± 3.12 teeth, p< 0.001). Favourable HDL was measured among most patients (77%); other favourable clinical measures occurred only in a minority of participants (HbA1c, 28%; fasting blood glucose, 17%; LDL, 30%). Twice daily toothbrushing was reported by 33% (17%) for healthy BMI; 37% when healthy body-fat proportions. There was risk of sleep apnea in 37 %. The higher number of lost teeth in the maxilla was linked with obesity and sleep apnea. Non-daily toothbrushers were more likely to have high LDL and low HDL cholesterol and a higher risk of sleep apnea. When "at least occasionally" bleeding on toothbrushing occurred, higher HbA1c levels and sleep apnea were more likely. CONCLUSION: Oral care with early diagnosis and monitoring of glycaemic level can help prevent complications of DM2. CLINICAL RELEVANCE: Dentists may play a key role in better managing and diagnosing sleep apnea early by referring the patients with severe tooth loss and periodontal disease for general medical examination.
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