Low education is associated with poor periodontal status in patients with type 2 diabetes mellitus: A cross-sectional study

Tatsuo Yamamoto; Michio Tanaka; Nobuichi Kuribayashi; Fuminobu Okuguchi; Haruhiko Isotani; Masahiro Iwamoto; Hidekatsu Sugimoto; Osamu Nakagawa; Masato Minabe; Shinya Fuchida; Yuki Mochida; Hiroki Yokoyama

doi:10.1002/cre2.363

Low education is associated with poor periodontal status in patients with type 2 diabetes mellitus: A cross-sectional study

Clin Exp Dent Res. 2021 Aug;7(4):419-428. doi: 10.1002/cre2.363. Epub 2020 Nov 30.

Authors

Affiliations

¹ Department of Disaster Medicine and Dental Sociology, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan.
² Misaki Naika Clinic, Funabashi, Japan.
³ Okuguchi Clinic of Internal Medicine, Sendai, Japan.
⁴ Isotani Diabetes Clinic, Hirakata, Japan.
⁵ Iwamoto Internal Medicine Clinic, Zentsuji, Japan.
⁶ Sugimoto Clinic, Kitakyushu, Japan.
⁷ Nakagawa Internal Medicine Clinic, Sanjo, Japan.
⁸ Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan.
⁹ Internal Medicine, Jiyugaoka Medical Clinic, Obihiro, Japan.

Abstract

Objectives: Cardiovascular disease remains the most common cause of death in patients with type 2 diabetes mellitus. Because periodontitis is a risk factor of cardiovascular disease, identification of risk factors of periodontitis is valuable to control periodontitis effectively. The purpose of this study was to examine the association of education and household income with periodontal status in patients with type 2 diabetes mellitus.

Methods: Participants were 2,436 patients (59.8% male, aged 29-93 years) with type 2 diabetes mellitus from 27 medical clinics. Participants' medical records and information about education, household income, general health status, and health behaviors were collected. Periodontal status was assessed in a nearby dental office. Multiple linear regression analyses and ordered logistic regression analyses were conducted to examine the association of periodontal parameters with education and household income after adjusting for age, sex, general health status, and health behaviors.

Results: Multiple linear regression analysis showed that mean probing pocket depth was not significantly associated with education and household income. Ordered logistic regression analyses showed statistically significant odds ratios (ORs) of junior high school (reference: university) for the tertiles of the percentage of sites with bleeding on probing (OR: 1.42; 95% confidence interval [CI]: 1.11-1.81), percentage of mobile teeth (OR: 1.58; 95% CI: 1.24-2.03), and number of teeth present (OR: 0.51; 95% CI: 0.39-0.65), and statistically significant odds ratios of high school (reference: university) for the tertiles of the percentage of mobile teeth (OR: 1.27; 95% CI: 1.06-1.51) and number of teeth present (OR: 0.74; 95% CI: 0.62-0.88), but not household income.

Conclusions: These results suggest that low education is one of the important predictors of poor periodontal status in patients with type 2 diabetes mellitus. It is important to provide targeted interventions including periodontal education in junior high school.

Keywords: education; income; periodontal disease; type 2 diabetes mellitus.

MeSH terms

Cardiovascular Diseases*
Cross-Sectional Studies
Diabetes Mellitus, Type 2* / complications
Diabetes Mellitus, Type 2* / epidemiology
Educational Status
Female
Humans
Male
Periodontitis*