Impact of periodontal status on oral health-related quality of life in patients with and without type 2 diabetes.

OBJECTIVES: To investigate the impact of periodontal status on oral health-related quality of life (OHRQoL) in patients with and without type 2 diabetes mellitus (T2DM).

METHODS: 61 patients with T2DM and 74 non-diabetic patients matched for age, gender and periodontal status (health, gingivitis, chronic periodontitis) were recruited. The oral health impact profile (OHIP)-49 was self-completed by all participants at baseline and by the patients with periodontitis at 3 months and 6 months after non-surgical periodontal therapy.

RESULTS: There were no significant differences in the overall OHIP-49 summary scores between patients with T2DM (median; interquartile range; 37.0; 19.5-61.0) and without T2DM (30.4; 16.8-51.0) (p>0.05). Among non-diabetic patients, there were significantly higher OHIP-49 scores (indicating poorer OHRQoL) in patients with gingivitis (41.0; 19.7-75.7) and periodontitis (33.0; 19.9-52.5) compared to patients who were periodontally healthy (11.1; 7.1-34.5) (p<0.05), though such an effect was not observed in the patients with diabetes. In the non-diabetic patients with periodontitis, statistically significant reductions in OHIP-49 scores were noted in the psychological discomfort and psychological disability domains following periodontal treatment, indicating an improvement in OHRQoL. In contrast, there were no statistically significant changes in OHIP-49 scores following periodontal treatment in the patients with diabetes.

CONCLUSION: T2DM does not impact on overall OHRQoL as measured by OHIP-49. Chronic periodontitis and gingivitis were associated with poorer OHRQoL in non-diabetic patients, with evidence of improvements following periodontal treatment, but no such effects were observed in patients with diabetes.

CLINICAL SIGNIFICANCE: Gingivitis and periodontitis are associated with reduced OHRQoL compared to periodontal health in non-diabetic patients, with improvements following treatment of periodontitis. No impact of type 2 diabetes on OHRQoL was noted; this may be related to the burden of chronic disease (diabetes) minimising the impact of oral health issues on OHRQoL.