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Risk of complications among diabetics self-reporting oral health status in Canada: A population-based cohort study


Autoři: Kamini Kaura Parbhakar aff001;  Laura C. Rosella aff002;  Sonica Singhal aff001;  Carlos R. Quiñonez aff001
Působiště autorů: Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada aff001;  Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada aff002;  Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada aff003;  Public Health Ontario Toronto, Ontario, Canada aff004
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0218056

Souhrn

Background

Periodontitis has been associated with diabetes and poor health. While clear associations have been identified for the diabetes–oral health link, less is known about the implications of poor oral health status for incident complications of diabetes. This study investigated the risk of diabetes complications associated with self-reported “poor to fair” and “good to excellent” oral health among diabetics living in Ontario, Canada.

Methods

This was a cohort study of diabetics who took part in the Canadian Community Health Survey (2003 and 2007–08). Self-reported oral health was linked to electronic health records held at the Institute for Clinical Evaluative Sciences. Participants aged 40 years and over, who self-reported oral health status in linked databases were included (N = 5,183). Cox proportional hazard models were constructed to determine the risk of diabetes complications. Participants who did not experience any complications were censored. Models were adjusted for age and sex, followed by social characteristics and behavioural factors. The population attributable risk of diabetes complications was calculated using fully adjusted hazard ratios.

Results

Diabetes complications differed by self-reported oral health; 35% of the total sample experienced a complication and 34% of those reporting “good to excellent” oral health (n = 4090) experienced a complication in comparison to 38% of those with “fair to poor” oral health (n = 1093). For those reporting “poor to fair” oral health, the hazard of a diabetes complication was 30% greater (HR 1.29; 95% CI: 1.03, 1.61) than those reporting “good to excellent” oral health. The population level risk of complications attributable to oral health was 5.2% (95% CI: 0.67, 8.74).

Conclusions

Our findings indicate that reporting “poor to fair” oral health status may be attributed to health complications among diabetics, after adjusting for a wide range of confounders. This has important public health implications for diabetics in Ontario, Canada.

Klíčová slova:

Behavioral and social aspects of health – Canada – diabetes mellitus – Electronic medical records – Inflammatory diseases – Ontario – Oral health – Periodontal diseases


Zdroje

1. Public Health Agency of Canada. Diabetes in Canada: Facts and figures from a public health perspective [Internet]. 2011. Available from: http://www.phac-aspc.gc.ca/cd-mc/diabetes-diabete/index-eng.php

2. Statistics Canada. Leading causes of death, total population, by age group [Internet]. Statistics Canada. 2017. Available from: https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310039401

3. Canadian Diabetes Association. Charter BackgrounderDiabetes in Canada [Internet]. 2018 [cited 2018 Sep 19]. Available from: https://www.canada.ca/content/dam/phac-aspc/migration/phac-aspc/cd-

4. Simpson TC, Weldon JC, Worthington H V, Needleman I, Wild SH, Moles DR, et al. Treatment of periodontal disease for glycaemic control in people with diabetes mellitus. Cochrane Database Syst Rev [Internet]. 2015 Nov 6 [cited 2018 Aug 14];(11). Available from: http://doi.wiley.com/10.1002/14651858.CD004714.pub3

5. Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJL, Marcenes W. Global Burden of Severe Periodontitis in 1990–2010. J Dent Res [Internet]. 2014 Nov 26 [cited 2018 Oct 11];93(11):1045–53. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25261053 doi: 10.1177/0022034514552491 25261053

6. Tonetti MS, Jepsen S, Jin L, Otomo-Corgel J. Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: A call for global action. J Clin Periodontol [Internet]. 2017 [cited 2018 Aug 22];44:456–62. Available from: https://onlinelibrary.wiley.com/doi/pdf/10.1111/jcpe.12732 28419559

7. Kassebaum NJ, Smith AGC, Bernabé E, Fleming TD, Reynolds AE, Vos T, et al. Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990–2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. J Dent Res [Internet]. 2017 Apr 1 [cited 2018 Aug 14];96(4):380–7. Available from: http://journals.sagepub.com/doi/10.1177/0022034517693566 28792274

8. Summary Report on the Findings of the Oral Health Component of the Canadian Health Measures Survey 2007–2009 [Internet]. 2010. Available from: http://publications.gc.ca/collections/collection_2010/sc-hc/H34-221-1-2010-eng.pdf

9. Zuk A, Quiñonez C, Lebenbaum M, Rosella LC. The association between undiagnosed glycaemic abnormalities and cardiometabolic risk factors with periodontitis: results from 2007–2009 Canadian Health Measures Survey. J Clin Periodontol [Internet]. 2017 Feb 1 [cited 2019 Apr 30];44(2):132–41. Available from: http://doi.wiley.com/10.1111/jcpe.12684 28028834

10. Hajishengallis G. The inflammophilic character of the periodontitis-associated microbiota. Mol Oral Microbiol. 2014;

11. Chee B, Park B, Bartold PM. Periodontitis and type II diabetes: A two-way relationship. International Journal of Evidence-Based Healthcare. 2013;

12. Taylor GW, Borgnakke WS. Periodontal disease: Associations with diabetes, glycemic control and complications. Oral Dis. 2008;14(3):191–203. doi: 10.1111/j.1601-0825.2008.01442.x 18336370

13. Hasturk H, Kantarci A, Van Dyke TE. Oral Inflammatory Diseases and Systemic Inflammation: Role of the Macrophage. Front Immunol [Internet]. 2012 May 16 [cited 2018 Aug 15];3:118. Available from: http://journal.frontiersin.org/article/10.3389/fimmu.2012.00118/abstract 22623923

14. de Oliveira C, Watt R, Hamer M. Toothbrushing, inflammation, and risk of cardiovascular disease: results from Scottish Health Survey. BMJ [Internet]. 2010 May 27 [cited 2018 Aug 14];340:c2451. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20508025 doi: 10.1136/bmj.c2451 20508025

15. Tsakos G, Quiñonez C. A sober look at the links between oral and general health. J Epidemiol Community Health [Internet]. 2013 May [cited 2019 Aug 9];67(5):381–2. Available from: http://jech.bmj.com/lookup/doi/10.1136/jech-2013-202481 23486923

16. Albert DA, Sadowsky D, Papapanou P, Conicella ML, Ward A. An examination of periodontal treatment and per member per month (PMPM) medical costs in an insured population. BMC Health Serv Res [Internet]. 2006 Aug 16 [cited 2018 Aug 14];6:103. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16914052 doi: 10.1186/1472-6963-6-103 16914052

17. Jeffcoat MK, Jeffcoat RL, Gladowski PA, Bramson JB, Blum JJ. Impact of Periodontal Therapy on General Health: Evidence from Insurance Data for Five Systemic Conditions. Am J Prev Med [Internet]. 2014 Aug 1 [cited 2018 Aug 14];47(2):166–74. Available from: https://www.sciencedirect.com/science/article/pii/S0749379714001536?via%3Dihub doi: 10.1016/j.amepre.2014.04.001 24953519

18. Nasseh K, Vujicic M, Glick M. The Relationship between Periodontal Interventions and Healthcare Costs and Utilization. Evidence from an Integrated Dental, Medical, and Pharmacy Commercial Claims Database. Health Econ [Internet]. 2017 Apr 1 [cited 2018 Aug 14];26(4):519–27. Available from: http://doi.wiley.com/10.1002/hec.3316 26799518

19. Kebede TG, Pink C, Rathmann W, Kowall B, Völzke H, Petersmann A, et al. Does periodontitis affect diabetes incidence and haemoglobin A1c change? An 11-year follow-up study. Diabetes Metab [Internet]. 2018 Jun [cited 2018 Aug 14];44(3):243–9. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1262363617305761 doi: 10.1016/j.diabet.2017.11.003 29249612

20. Diabetes Canada. Diabetes in Canada [Internet]. [cited 2018 Aug 14]. Available from: https://www.canada.ca/content/dam/phac-aspc/migration/phac-aspc/cd-

21. Bilandzic A, Rosella L. The cost of diabetes in Canada over 10 years: applying attributable health care costs to a diabetes incidence prediction model. Heal Promot chronic Dis Prev Canada Res policy Pract [Internet]. 2017 Feb [cited 2018 Oct 12];37(2):49–53. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28273040

22. Statistics Canada. Canadian Community Health Survey—Annual Component (CCHS) [Internet]. [cited 2018 Aug 15]. Available from: http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=3226

23. Hux JE, Ivis F, Flintoft V, Bica A. Diabetes in Ontario Determination of prevalence and incidence using a validated administrative data algorithm [Internet]. [cited 2018 Aug 15]. Available from: http://care.diabetesjournals.org/content/25/3/512.full-text.pdf

24. Thomas S, Wannell B. Combining cycles of the Canadian Community Health Survey. Heal Reports. 2009;20(1):55–60.

25. Booth G, Polsky J, Gozdyra G, Caucg-Dudek K, Kiran T, Shah B, et al. Regional Measures of Diabetes Burden in Ontario [Internet]. 2012 [cited 2018 Aug 16]. Available from: https://www.ices.on.ca/Publications/Atlases-and-Reports/2012/Regional-Measures-of-Diabetes-Burden-in-Ontario

26. Canadian Community Health Survey (CCHS) Cycle 2.1 Public Use Microdata File (PUMF) Derived and Grouped Variable Specifications Statistics Canada [Internet]. 2005 [cited 2018 Nov 26]. Available from: http://sda.chass.utoronto.ca/sdaweb/dli/cchs/cchs_21/more_doc/derive_e.pdf

27. Glazier R, Zagorski B, Rayner J. Comparison of Primary Care Models in Ontario by Demographics, Case Mix and Emergency Department Use, 2008/09 to 2009/10 [Internet]. 2012 [cited 2018 Aug 20]. Available from: www.ices.on.ca

28. Hosmer DW, Lemeshow S, May S. Applied survival analysis: regression modeling of time-to-event data [Internet]. Wiley-Interscience; 2008 [cited 2018 Aug 30]. 392 p. Available from: https://books.google.ca/books/about/Applied_Survival_Analysis.html?id=IvvOopIqzWsC&printsec=frontcover&source=kp_read_button&redir_esc=y#v=onepage&q&f=false

29. Sardarinia M, Akbarpour S, Lotfaliany M, Bagherzadeh-Khiabani F, Bozorgmanesh M, Sheikholeslami F, et al. Risk Factors for Incidence of Cardiovascular Diseases and All-Cause Mortality in a Middle Eastern Population over a Decade Follow-up: Tehran Lipid and Glucose Study. 2016;

30. SAS Institute Inc., Cary, NC, USA. Reprinted with permission. All rights reserved [Internet]. Available from: https://www.sas.com/content/dam/SAS/en_us/doc/other1/editorial-guidelines.pdf

31. Borgnakke WS, ostalo P V., Taylor GW, Genco RJ. Effect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence. J Periodontol [Internet]. 2013 Apr;84(4-s):S135–52. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23631574

32. Sharma P, Dietrich T, Ferro CJ, Cockwell P, Chapple ILC. Association between periodontitis and mortality in stages 3–5 chronic kidney disease: NHANES III and linked mortality study. J Clin Periodontol [Internet]. 2016 Feb 1 [cited 2018 Oct 9];43(2):104–13. Available from: http://doi.wiley.com/10.1111/jcpe.12502 26717883

33. Chapple ILC, Genco R. Diabetes and periodontal diseases: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. J Clin Periodontol [Internet]. 2013 Apr [cited 2018 Oct 8];40:S106–12. Available from: http://doi.wiley.com/10.1111/jcpe.12077 23627322

34. Tonetti MS, Van Dyke TE, working group 1 of the joint EFP/AAP workshop. Periodontitis and atherosclerotic cardiovascular disease: consensus report of the Joint EFP/AAPWorkshop on Periodontitis and Systemic Diseases. J Periodontol [Internet]. 2013 Apr [cited 2018 Oct 22];84(4-s):S24–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23631582

35. MOUTSOPOULOS NM, MADIANOS PN. Low-Grade Inflammation in Chronic Infectious Diseases: Paradigm of Periodontal Infections. Ann N Y Acad Sci [Internet]. 2006 Nov 1 [cited 2018 Aug 22];1088(1):251–64. Available from: http://doi.wiley.com/10.1196/annals.1366.032

36. Daudt LD, Musskopf ML, Mendez M, Remonti LLR, Leitão CB, Gross JL, et al. Association Between Metabolic Syndrome and Periodontitis: A Systematic Review and Meta-analysis. Braz Oral Res. 2018;

37. Shearer DM, Thomson WM, Broadbent JM, Mann J, Poulton R. Periodontitis is not associated with metabolic risk during the fourth decade of life. J Clin Periodontol. 2017 Jan 1;44(1):22–30. doi: 10.1111/jcpe.12641 27783846

38. Wellappuli N, Fine N, Lawrence H, Goldberg M, Tenenbaum H, Glogauer M. Oral and Blood Neutrophil Activation States during Experimental Gingivitis. J Dent Res Clin Transl Res [Internet]. 2018 [cited 2019 May 14];3(1):65–75. Available from: https://journals.sagepub.com/doi/pdf/10.1177/2380084417742120

39. Salvi GE, Kandylaki M, Troendle A, Persson GR, Lang NP. Experimental gingivitis in type 1 diabetics: a controlled clinical and microbiological study. J Clin Periodontol [Internet]. 2005 Mar 1 [cited 2019 May 14];32(3):310–6. Available from: http://doi.wiley.com/10.1111/j.1600-051X.2005.00682.x 15766376

40. Benyamini Y. Health and Illness Perceptions [Internet]. Oxford University Press; 2011 [cited 2018 Aug 23]. Available from: http://oxfordhandbooks.com/view/10.1093/oxfordhb/9780195342819.001.0001/oxfordhb-9780195342819-e-013

41. Wiener RC, Dwibedi N, Shen C, Findley PA, Sambamoorthi U. Clinical Oral Health Recommended Care and Oral Health Self-Report, NHANES, 2013–2014. Adv Public Heal [Internet]. 2018 Jun 26 [cited 2018 Aug 23];2018:1–9. Available from: https://www.hindawi.com/journals/aph/2018/1893562/

42. Ma TE Lo, Lagaya-Estrada L, Jimeno C, Jasul G. Validation of self-reported oral health measures for predicting periodontitis among adult Filipinos with type 2 diabetes mellitus. Endocr Abstr [Internet]. 2015 [cited 2018 Aug 23];37(411). Available from: https://www.endocrine-abstracts.org/ea/0037/ea0037EP411.htm

43. Farmer J, Ramraj C, Azarpazhooh A, Dempster L, Ravaghi V, Quiñonez C. Comparing self-reported and clinically diagnosed unmet dental treatment needs using a nationally representative survey. J Public Health Dent [Internet]. 2017 Sep 1 [cited 2018 Aug 27];77(4):295–301. Available from: http://doi.wiley.com/10.1111/jphd.12205 28195331

44. Elangovan S, Hertzman-Miller R, Karimbux N, Giddon D. A framework for physician-dentist collaboration in diabetes and periodontitis. Clin Diabetes [Internet]. 2014 Oct [cited 2018 Aug 28];32(4):188–92. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25646947 doi: 10.2337/diaclin.32.4.188 25646947

45. Pumerantz AS, Bissett SM, Dong F, Ochoa C, Wassall RR, Davila H, et al. Standardized screening for periodontitis as an integral part of multidisciplinary management of adults with type 2 diabetes: an observational cross-sectional study of cohorts in the USA and UK. BMJ Open Diabetes Res Care [Internet]. 2017 Jul 7 [cited 2018 Aug 28];5(1):e000413. Available from: http://drc.bmj.com/lookup/doi/10.1136/bmjdrc-2017-000413 28761663

46. Maxey H. Integration of Oral Health with Primary Care in Health Centers: Profiles of Five Innovative Models [Internet]. 2017 [cited 2018 Aug 28]. Available from: http://www.nachc.org/wp-content/uploads/2015/06/Integration-of-Oral-Health-with-Primary-Care-in-Health-Centers.pdf

47. Rothman KJ, Greenland S, Lash TL. Modern Epidemiology. Modern Epidemiology. Lippincot Williams & Wilkins; 2008. 758 p.

48. Singer M, Bulled N, Ostrach B, Mendenhall E. Syndemics and the biosocial conception of health. Lancet [Internet]. 2017 Mar 4 [cited 2018 Aug 28];389(10072):941–50. Available from: https://www.sciencedirect.com/science/article/pii/S014067361730003X doi: 10.1016/S0140-6736(17)30003-X 28271845

49. Hein C, Small D. Combating diabetes, obesity, periodontal disease and interrelated inflammatory conditions with a syndemic approach. Gd Rounds Oral-Sys Med [Internet]. 2006 [cited 2018 Aug 23];2:36–47. Available from: www.thesystemiclink.com.

50. Watt RG, Sheiham A. Integrating the common risk factor approach into a social determinants framework. Community Dent Oral Epidemiol. 2012;(40):289–96.

51. Gatehouse J. NDP’s dental plan seen as smart policy—but some costs are uncertain | CBC News [Internet]. 2019 [cited 2019 Oct 30]. Available from: https://www.cbc.ca/news/politics/ndp-dental-plan-fact-check-1.5289005


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