Oral Manifestations and Dental Health Status Among Patients with Type 2 Diabetes Mellitus: A Case-Control Study from a Private Dental Clinic in Baghdad, Iraq
Type 2 diabetes mellitus; oral manifestations; periodontal disease; xerostomia; DMFT; Baghdad; Iraq
AuthorsAbstractBackground: T2DM affects many systems in the body, and one of the areas most susceptible to chronic hyperglycaemia is the oral cavity. Despite the growing prevalence of T2DM in Iraq, there is limited research on its effects on oral health. Aim: Assess the patterns and prevalence of oral manifestation as well as dental health status of T2DM patients presenting to a private dental clinic in Baghdad, Iraq and compare this to a similar cohort of non-diabetic patients. Methods: 120 T2DM patients were compared to 60 age- and sex-matched non-diabetic individuals through a case-control study (Jan - Dec 2023). Complete oral examinations were performed using the Decayed, Missing, and Filled Teeth (DMFT) index, Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD), Clinical Attachment Loss (CAL), and unstimulated saliva flow. Oral manifestations were thoroughly documented. Integrated glycaemic control was assessed through glycated haemoglobin (HbA1c). Results: 81.7% of T2DM patients exhibited periodontal disease compared to 40% of non-diabetic controls (OR 6.80; 95% CI 3.28-14.10; P < 0.001). Diabetic patients experienced significantly higher rates of xerostomia (71.7% vs. 20%), oral candidiasis (43.3% vs. 6.7%), and burning mouth syndrome (34.2% vs. 10%). The DMFT and PPD were also considerably higher amongst diabetics (DMFT 16.3 ± 5.1 vs 9.7 ± 4.2; P < 0.001; PPD 4.71 ± 1.32 mm vs. 2.88 ± 0.94 mm; P < 0.001). Glycated haemoglobin (HbA1c) positively correlated with the DMFT, PPD, and CAL indices (r = 0.61, 0.63, and 0.66 respectively; all P < 0.001), and negatively correlated with salivary flow (r = -0.58; P < 0.001). Conclusions: Patients with T2DM in the Baghdad exhibit a significantly poorer oral health status. There is a strong correlation between the severity of the deterioration in oral health and glycaemic control, demonstrating a need for integrated approaches to diabetic and dental health care in clinical settings throughout Iraq.
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