Relationship between periodontitis and diabetes among adults in Brunei Darussalam

Periodontitis is one of the major causes of tooth loss and is consistently associated with various systemic diseases (periodontitis is often considered as the 6th complication of diabetes). The association of periodontitis and diabetes are well documented and a plausible biological mechanism associated with capillary dysfunction has been identified. In Brunei, there is no systematic linking of medical and dental providers in the management of patients with diabetes. The aim of this study was to evaluate some of the factors associated with periodontitis in adults with and without diabetes in Brunei Darussalam. Information on variables including gender, age, socio-economic status, smoking, fasting blood glucose levels (FBG) and periodontal health status of patients with diabetes and patients without diabetes were obtained from the Integrated Health Screening and Promotion for Civil Services (IHS) program. The study population comprised of 259 participants with diabetes (46.5%), and 298 without diabetes (53.5%). Patients with diabetes were 3 times more likely to have severe periodontitis (13.5%) compared to participants without diabetes (4.4%). Patients with undiagnosed diabetes were 12 fold and 1.5 fold more likely to have severe periodontitis compared to participants without diabetes and patients with uncontrolled diabetes respectively. In the study it was observed that patients with diabetes were more likely to suffer from severe periodontitis, especially if they were smokers or their diabetes was uncontrolled or undiagnosed. Among participants with and without diabetes, both age and socioeconomic status (SES) were significantly associated with severe periodontitis. It is recommended that dental care should be included in the management of patients with diabetes.