Tobacco smoking decreases clinical symptoms of gingivitis in patients with type 1 diabetes-a cross-sectional study

Oral Dis. 2018 Oct;24(7):1336-1342. doi: 10.1111/odi.12889. Epub 2018 May 29.

Abstract

Objective: Periodontal disease may develop on the background of microvascular complications of diabetes. However, some modifying factors, such as tobacco smoking, should be taken into consideration when assessing risk of development of chronic complications. The aim of the study was the clinical assessment of the periodontal status in patients with type 1 diabetes according to tobacco smoking.

Subjects and methods: A total of 362 subjects aged 29 (IQR 22-35) years, type 1 diabetes duration 12 (8-18) years, hemoglobin A1c, HbA1c 8.0 (7.2-9.1)% were included. We used Gingival Index, Approximal Plaque Index, and Sulcus Bleeding Index to assess periodontal health. Patients were divided into two subgroups according to current cigarette smoking.

Results: No differences in age, diabetes duration, and chronic complications were found between subgroups. A better metabolic control of diabetes expressed by lower HbA1c (p = 0.00001) and triglyceride levels (p = 0.004) was shown in nonsmokers. Smokers presented significantly lower gingival bleeding, p = 0.009. HbA1c correlated with API in study group (Rs = 0.16; p = 0.002) and in nonsmokers subgroup (Rs = 0.2;p = 0.004), however, not in smoker's subgroup. In multivariable regression analysis, smoking cigarettes (β = -0.26; p = 0.0002), hs-CRP (β = 0.15; p = 0.03) and age (β = -0.19; p = 0.007) occurred to be independent predictors of SBI after adjustment for confounding variables (R2 = 0.13; p = 0.001).

Conclusions: Patients with type 1 diabetes smoking cigarettes presented lower gingival sulcus bleeding and worse metabolic control of diabetes than nonsmoking patients.

Keywords: gingival bleeding; tobacco smoking; type 1 diabetes.

MeSH terms

  • Adult
  • Age Factors
  • C-Reactive Protein / metabolism
  • Cigarette Smoking* / blood
  • Cross-Sectional Studies
  • Dental Plaque Index
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications*
  • Female
  • Gingivitis / etiology
  • Gingivitis / prevention & control*
  • Glycated Hemoglobin / metabolism
  • Humans
  • Male
  • Non-Smokers
  • Periodontal Index
  • Triglycerides / blood
  • Young Adult

Substances

  • Glycated Hemoglobin A
  • Triglycerides
  • hemoglobin A1c protein, human
  • C-Reactive Protein