Association between poor oral health and diabetes among Indian adult population: potential for integration with NCDs

• Type of Material: Article
• Authors: Ishita Rawal, Centre for Chronic Disease Control; Shreeparna Ghosh, Immunization Technical Support Unit; Safraj Shahul Hameed, Centers for Disease Control and Prevention; Roopa Shivashankar, Centre for Chronic Disease Control; Vamadevan S. Ajay, Centre for Chronic Disease Control; Shivani A Patel, Emory University; Michael Goodman, Emory University; Mohammed Ali, Emory University; K.M. Venkat Narayan, Emory University; Nikhil Tandon, All India Institute of Medical Sciences; Dorairaj Prabhakaran, Centre for Chronic Disease Control
• Language: English
• Date: 2019-08-20
• Publisher: BMC (part of Springer Nature)
• Publication Version: Final Published Version
• Copyright Statement: © 2019 The Author(s).
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12903-019-0884-4
• Title of Journal or Parent Work: BMC Oral Health
• ISSN: 1472-6831
• Volume: 19
• Issue: 1
• Start Page: 191
• End Page: 191
• Grant/Funding Information: RS was supported by a Wellcome Trust Capacity Strengthening Strategic Award Extension phase to the Public Health Foundation of India and a consortium of UK universities (WT084754/Z/08/A).; This project is funded in part by the National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Department of Health and Human Services, under Contract No. HHSN268200900026C, and the United Health Group, Minneapolis, MN, USA.; Several members of the research team were/are supported by the Fogarty International Center (FIC) and the Eunice Kennedy Shriver National Institute of Child Health & Human Development at the National Institutes of Health through Grant Number 1 D43 HD065249, Fogarty International Center of the National Institutes of Health under Award Number D43TW009135 and NIH, National Cancer Institute grant number P20CA210298–01.
• Keywords: COUNTRIES; Periodontitis; Dentistry, Oral Surgery & Medicine; and middle-income countries; RISK; Low; Non-communicable diseases; Science & Technology; PERIODONTAL-DISEASE; DENTAL-CARIES; Diabetes; Dental caries; PREVALENCE; GLOBAL BURDEN; Life Sciences & Biomedicine; GLYCEMIC CONTROL
• Research Categories: Health Sciences, Public Health; Health Sciences, Dentistry

Abstract

Background: Studies in high-income countries have reported associations between oral health and diabetes. There is however a lack of evidence on this association from low and middle-income countries, especially India. The current study aimed to assess the prevalence of common oral diseases and their association with diabetes. Methods: This cross-sectional study was nested within the second Cardiometabolic Risk Reduction in South Asia Surveillance Study. A subset of study participants residing in Delhi were administered the World Health Organization's Oral Health Assessment Questionnaire and underwent oral examination for caries experience and periodontal health assessment using standard indices. Diabetes status was ascertained by fasting blood glucose, glycosylated hemoglobin values or self-reported medication use. Information was captured on co-variates of interest. The association between oral health and diabetes was investigated using Multivariable Zero-Inflated Poisson (ZIP) regression analysis. Results: Out of 2045 participants, 47% were women and the mean age of study participants was 42.17 (12.8) years. The age-standardised prevalence (95% confidence interval) estimates were 78.9% (75.6-81.7) for dental caries, 35.9% (32.3-39.6) for periodontitis. Nearly 85% participants suffered from at least one oral disease. Compared to diabetes-free counterparts, participants with diabetes had more severe caries experience [Mean Count Ratio (MCR) = 1.07 (1.03-1.12)] and attachment loss [MCR = 1.10 (1.04-1.17)]. Also, the adjusted prevalence of periodontitis was significantly higher among participants with diabetes [42.3%(40.0-45.0)] compared to those without diabetes [31.3%(30.3-32.2)]. Conclusion: We found that eight out of ten participants in urban Delhi suffered from some form of oral disease and participants with diabetes had worse oral health. This highlights the need for public health strategies to integrate oral health within the existing Non-Communicable Disease control programs.