Relationship between oral health, diabetes management and sleep apnea.

OBJECTIVES

The aim of this study was to assess the relationship between tooth loss, toothbrushing behaviour, diabetes type 2 (DM2), obesity and sleep apnea among diabetics.

MATERIAL AND METHODS

DM2 patients (n = 165) in Istanbul, Turkey, were randomly selected from the outpatient clinics of two hospitals. Baseline clinical measurements (HbA1c, fasting blood glucose, high-density lipoprotein (HDL), low-density lipoprotein (LDL), body mass index (BMI), body-fat proportion, tooth loss) and self-administered questionnaires (toothbrushing, gingival bleeding, sleep apnea) provided data for factor and principal component analysis with Varimax rotation. Univariate statistics and chi-square tests were derived.

RESULTS

Mean maxillary tooth loss (4.49 ± 3.69 teeth) was higher than in the mandible (3.43 ± 3.12 teeth, p< 0.001). Favourable HDL was measured among most patients (77%); other favourable clinical measures occurred only in a minority of participants (HbA1c, 28%; fasting blood glucose, 17%; LDL, 30%). Twice daily toothbrushing was reported by 33% (17%) for healthy BMI; 37% when healthy body-fat proportions. There was risk of sleep apnea in 37 %. The higher number of lost teeth in the maxilla was linked with obesity and sleep apnea. Non-daily toothbrushers were more likely to have high LDL and low HDL cholesterol and a higher risk of sleep apnea. When "at least occasionally" bleeding on toothbrushing occurred, higher HbA1c levels and sleep apnea were more likely.

CONCLUSION

Oral care with early diagnosis and monitoring of glycaemic level can help prevent complications of DM2.

CLINICAL RELEVANCE

Dentists may play a key role in better managing and diagnosing sleep apnea early by referring the patients with severe tooth loss and periodontal disease for general medical examination.