Diabetes type, hemoglobin A1C biomarker and control as predictors for dental treatment needs

Introduction: The goal of this study was to test the impact of both diabetes type and control via the hemoglobin A1C biomarker on oral health outcomes. Materials Methods: In this observational study, data were extracted from the University of Pittsburgh Dental Registry and DNA Repository and analyzed. From 6,026 subjects, 414 ones with a diagnosis of diabetes were matched by sex, age and ethnicity with 414 individuals without diabetes. A number of statistical approaches (chi-square, Fisher’s exact, Student’s t, Wilcox, and Mann Whitney tests) were used and all comparisons were set with an alpha of 0.05. Results: Patients with type 1 diabetes experienced xerostomia more often compared to non diabetic matched pairs (p=0.02). Patients with diabetes (n=414) experienced temporomandibular joint (TMJ) discomfort more often than their non-diabetic matched pairs, as did type 1 diabetic patients alone, in comparison to both their matched pairs and type 2 diabetic patients (p=0.01, p=0.004, and p=0.02, respectively). Among patients grouped by diabetic control, all patients reporting control (n=39) experienced xerostomia more often than their non-diabetic matched pairs (p=0.05). Patients in poor diabetic control experienced restoration failure more often than patients in good control (p=0.04). The experience of restoration failure was no different between patients in good diabetic control and their matched controls (p=0.26). The number of restoration failures was higher in patients in poor control, as compared to their matched non-diabetic controls (p=0.03). Conclusion: Patients with diabetes experienced xerostomia but not necessarily more severe caries experience, and may be protected from TMJ discomfort. Patients in good control of their diabetes were at no greater risk for restoration failure as compared to non-diabetic patients; however, the patients in poor control were at higher risk for failed restorations.