A new study from Columbia University Medical Center has shown that the destruction of the gums can start in diabetic children as young as six years old. While the link between diabetes and periodontal disease was previously established, it was believed that the regression of gums began much later and increased with age.
The study, a collaboration among researchers at the Columbia University College of Dental Medicine, Mailman School of Public Health and Naomi Berrie Diabetes Center, is published in the February issue of Diabetes Care.
"Our research illustrates that programs to prevent and treat periodontal disease should be considered a standard of care for young patients with diabetes," said Ira B. Lamster, D.D.S, M.M.Sc., dean of the College of Dental Medicine and principal investigator on the study, which is funded by the National Institute of Dental and Craniofacial Research.
"Other studies have shown that patients with diabetes are significantly less likely than those without diabetes to have seen a dentist within the past year," said Robin Goland, M.D., co-director of the Naomi Berrie Diabetes Center and a co-author of the paper. "This was due to a perceived lack of need, so clearly it's important that physicians and dentists and their patients with diabetes learn that they need to focus extra attention on oral health."
Oral health screenings are offered to all pediatric patients between the ages of 6 and 18 at the Naomi Berrie Diabetes Center, New York City's only comprehensive center for diabetes treatment, education and research.
The Columbia study clinically assessed dental cavities and periodontal disease in 182 children and adolescents, ages six to 18 years old, with diabetes, and 160 nondiabetic control subjects.
The children with diabetes had significantly more dental plaque and more gingival inflammation than children without diabetes. When gingivitis is left untreated, it can advance to periodontitis, in which the attachment of the gum and the supporting bone pull away from the teeth and form pockets that collect even more plaque. If left untreated, periodontitis can lead to tooth loss. Early signs of periodontal disease were found in nearly 60 percent of diabetic children in the six to 11-year-old group, twice the percentage found in the nondiabetic children in that age range - far younger than was previously believed to be affected. In the 12 to 18-year-old study group, nearly 80 percent of patients with diabetes had early periodontal changes.
The study is continuing, and will ultimately include 700 total participants. "It will be extremely interesting to see the results from the entire cohort and to further explore if specific diabetes-associated factors are related to the early development of periodontal disease" said Evanthia Lalla, D.D.S., M.S., associate professor of dentistry at the College of Dental Medicine and lead author of the study.