Prevalence of periodontal disease and associated factors of periodontitis among diabetic patients under follow up at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: Institution based cross sectional study
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Date
2023-07
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Addis Ababa University
Abstract
Introduction: Diabetes and periodontal disease are chronic diseases with a significant impact on
public health. The relationship between these two diseases has been well established and is said
to be bi-directional. Diabetes is a risk factor for periodontal disease, and periodontal disease may
have impact on glycemic status and other diabetic complications. There is a paucity of data
related to the prevalence and associated factors of periodontal disease among Ethiopian diabetic
patients.
Objective: The main objective of this study is to determine the prevalence of periodontal disease
and associated factors of periodontitis in diabetic patients attending their treatment and follow up
at Tikur Anbessa Specialized Hospital
Methods: An institution based cross sectional study was conducted from June 1-July 31, 2023
on sampled diabetic patients following in the endocrine clinic of Tikur Anbessa specialized
hospital during the study period. The study enrolled 216 diabetic patients in total. To examine
the prevalence of periodontal disease and associated factors for periodontits, data were collected
using a pretested questionnaire to assess sociodemographic, physical features, clinical
parameters, glycemic profile (FBS & HgA1C), and oral hygiene practices. Following that, an
oral examination was performed to determine bleeding on probing, community periodontal index
(CPI) and clinical attachment loss (CAL). The logistic regression analysis was used to examine
factors associated with periodontitis, and the ordinal regression analysis was used to estimate
severity based on CAL. Data collected was analysed using STATA version 14 software and
outcomes were presented by tables, figures and statements.
Results: The overall prevalence of periodontal disease (either gingivitis or periodontitis) was
100%, with gingivitis affecting 98.6% of subjects and periodontitis affecting 91.7%. Multivariate
analysis revealed Increasing age (AOR=1.06, 95% CI:1.01-1.11), use of combination
antihyperglycemic medications (either combination oral or combination oral & insulin)
(AOR=4.85, 95%:1.3-17.9), spironolactone use (AOR-0.21, 95% CI: 0.014-0.78) and presence
of dentures (AOR-0.34; 95% CI: 0.04-0.65) to be significantly associated with periodontitis.
In addition, bleeding on brushing was found to be significant indicator of periodontitis (AOR-
6.6; 95% CI: 1.5-34.5). Male gender (AOR-2.4, 95% CI: 1.08-5.36), lack of flossing (AOR-4.1,
95% CI: 0.04-1.04), and poor self perception of gum health (AOR-2.82, 95% CI: 1.25-6.38)
were variables significantly associated with the risk of developing generalized periodontitis.
Ordinal regression analysis showed that male gender (AOR-3.5, 95% CI: 1.4-8.7) and age ≥40
years (AOR-5.3, 95% CI: 1.4-20) were significantly related to periodontitis severity.
Conclusion: The finding of this study showed that the magnitude of periodontal disease among
diabetic patients was high. Increasing age, use of combination anti hyperglycemic drugs,
spironolactone use, presence of dentures, and bleeding on brushing were independently
associated with the occurrence of periodontitis. Furthermore, male gender and increasing age
were found to be significant predictors of the severity and development of generalized
periodontitis.
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Keywords
Diabetes, periodontal disease, periodontitis, gingivitis