Dental and periodontal health, and microbiological and salivary conditions in patients with or without diabetes undergoing haemodialysis

Int Dent J. 2017 Jun;67(3):186-193. doi: 10.1111/idj.12282. Epub 2017 Feb 2.

Abstract

Objective: The aim of this cross-sectional study was to evaluate the dental and periodontal health, as well as the microbiological and salivary conditions, of patients with and without diabetes mellitus (DM) who are receiving haemodialysis.

Methods: One-hundred and fifty-nine haemodialysis patients were included and divided into groups according to the pre-existing diabetes status: DM or no DM. The oral examination included dental findings and assessment of the periodontal situation. The periodontal condition was classified as healthy/mild, moderate or severe periodontitis. Subgingival biofilm samples were analysed using the polymerase chain reaction. The salivary diagnostics included measurement of unstimulated and stimulated salivary flow, pH and buffer capacity. Statistical analyses used Fisher's test, the t-test and the Mann-Whitney U-test (α = 5%).

Results: The dental findings showed no significant difference between patients with and without DM (P = 0.44). The prevalence of periodontitis was high (96% in patients with DM and 97% in patients who did not have DM) and there was no significant difference between the groups (P = 0.71). There was a higher prevalence of Porphyromonas gingivalis, Parvimonas micros, Eubacterium nucleatum and Capnocytophaga spp. in patients without DM (P < 0.05). The salivary pH was significantly higher in patients without DM (P < 0.01).

Conclusion: While differences in the prevalence of periodontal pathogenic bacteria and in the salivary pH were detected between the groups, the dental and periodontal status was comparable between patients with and without DM. Accordingly, DM appears to have no decisive influence on the oral health in patients treated with haemodialysis who have well-controlled diabetes.

Keywords: Haemodialysis; dental health; periodontal bacteria; periodontitis; saliva.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bacteria / isolation & purification
  • Bacteria / pathogenicity
  • Biofilms
  • Capnocytophaga / pathogenicity
  • Cross-Sectional Studies
  • Dental Plaque / microbiology
  • Diabetes Complications*
  • Diabetes Mellitus
  • Eubacterium / pathogenicity
  • Female
  • Germany
  • Gingival Hemorrhage / classification
  • Health Status
  • Humans
  • Hydrogen-Ion Concentration
  • Male
  • Middle Aged
  • Oral Health*
  • Periodontal Attachment Loss / classification
  • Periodontal Diseases / classification
  • Periodontal Diseases / complications
  • Periodontal Index
  • Periodontal Pocket
  • Periodontitis / complications*
  • Periodontitis / epidemiology
  • Periodontitis / microbiology*
  • Porphyromonas gingivalis / pathogenicity
  • Prevalence
  • Renal Dialysis*
  • Saliva / chemistry*
  • Salivation