Periodontal disease and risk for neuropathic foot ulceration in type 2 diabetes

Abstract 

Aims

Diabetic neuropathy (DN) has been associated with oral dryness, tooth loss and an increased risk for foot ulceration, but the association between periodontal problems and DN has not been fully elucidated. This study investigated whether the risk for neuropathic foot ulceration (DM-NFUR) was associated with periodontal disease (PD) in patients with type 2 diabetes mellitus.

Methods

This cross-sectional study examined 122 patients with type 2 diabetes for PD; findings were compared with results for presence of DM-NFUR. PD severity was classified as none/mild (NM-PD), moderate/severe (MS-PD) and edentulous (E).

Results

NM-PD was found in 40.2% patients; MS-PD, in 32.0%; and 27.8% were edentulous. DM-NFUR was detected in 18.4% of the patients in the NM-PD group, in 68.2% in the MS-PD group, and in 61.8% of completely edentulous individuals. PD was significantly correlated with DM-NFUR (p≤0.001). After adjustment for sex, age, diabetes duration, dental health care and education, PD and edentulism were independently associated with DM-NFUR (odds ratio_adjusted; 6.6; 95% CI 2.3–18.8; p≤0.001, and odds ratio_adjusted 4.9; 95% CI 1.6–15.3; p≤0.01).

Conclusions

Patients with DM-NFUR have substantially more MS-PD and edentulism. Further studies should evaluate whether diabetic neuropathy is a risk factor for PD.

Keywords: Periodontal disease, Type 2 diabetes mellitus, Diabetic foot and neuropathy