High Level of Gingival Inflammation in Subjects with Type 1 Diabetes Despite Regular Dental Visits and Limited Microvascular Complications

The aim of the study was to evaluate small fiber neuropathy and periodontal health conditions on a cohort of patients with type 1 diabetes. The study participants were 18 females and 23 males with a mean age of 37.9 years (age range: 18-83 years). First, a routine medical examination was conducted at the Diabetology Clinics of the Geneva Universtity Hospital. Electrochemical skin conductance (ESC) was measured by Sudoscan, a noninvasive tool for detecting diabetic small fiber neuropathy. Participants were further examined for presence of periodontal disease by means of Plaque and Gingival indices (PI and GI respectively), probing depth (PD) and bleeding on probing. Self-reported attitudes and behavior regarding dental care was also collected during the visit. The mean duration of affliction with diabetes was 14.6 ±11.9 years, with a mean glycosylated heamoglobin (HbA1c) of 7.96±1.68%. The Sudoscan measurements showed an average ESC value between right and left sides for the hands of 68.2±13.4 microSiemenns (µS) and for the feet an ESC value of 79±6.9 µS. Seven percent of the subjects presented moderate dysfunction (ESC values 60-40 µS) whereas only one subject presented severe dysnfunction (< 40 µS). The periodontal examination revealed that all patients (except from 2) had signs of gingivitis, defined as presence of at least 2 sites with a GI>1. Gingival inflammation and bleeding on probing was present in 66% of the participants in more than 20% of sites independently of the presence of small fiber neuropathy. Periodontitis was observed in 15% of the subjets with a mean of 13 sites with PD>4mm and bleeding on probing. The majority of subjects (70%) reported having regular dental visits at least once per year. In the present cohort of patients with type 1 diabetes the main finding was the occurrence of pronounced gingival inflammation in the majority of subjects independently of small fiber neuropathy and despite regular dental visits.