Journal of dental hygiene science (치위생과학회지)

The Korean Society of Dental Hygiene Science (한국치위생과학회)
권호 표지

Self-Perceived Oral Health Status according to Regulation of Blood Glucose in the Type 2 Diabetic Patients

제2형 당뇨병 환자에서 혈당조절에 따른 구강건강인식도

  • Kang, Hui-Eun (Department of Dental Hygiene, Graduate School of Public Health, Gachon University) ;
  • Kim, Sun-Ju (Department of Dental Hygiene, Cheongju University) ;
  • Choi, Jun-Seon (Department of Dental Hygiene, College of Health Science, Gachon University)
  • 강희은 (가천대학교 보건대학원 치위생학과) ;
  • 김선주 (청주대학교 치위생학과) ;
  • 최준선 (가천대학교 보건과학대학 치위생학과)
  • Published : 2012.10.31
⟨ Previous Next ⟩

Abstract

The aim of this study was to investigate the oral health problems among type 2 diabetes patients and suggest basic data for the promotion of their body and oral health by emphasizing the correlation between hemoglobin A1c and subjective oral health status. For 174 patients with type 2 diabetes and who were older than 40 years old, the questionnaire and measurement of hemoglobin A1c were conducted from January 9, 2012 to March 9, 2012. The results of the study were as follows. 1. They tended to be most aware of the following; 'inflammation on the oral mucosa' and 'pain on the oral mucosa' among the symptoms of oral mucosa, 'gum bleeding when brushing teeth' among the symptoms of periodontal disease, and 'feels dry in general' among the symptoms of xerostomia. 2. The patients with longer duration of diabetes showed greater recognition with regards to the symptoms of oral mucosa disease, periodontal disease, and xerostomia (p<0.05). 3. The group with regular meal showed lower level of hemoglobin A1c (p<0.001). 4. The level of hemoglobin A1c was higher in the group that recognized 'burning sensation', 'gum bleeding', 'gum recession' and 'bad breath' (p<0.05) as well as in the group that responded 'get up at night to drink' among the symptoms of xerostomia (p<0.05). Especially the symptoms of periodontal disease were revealed to be a factor that showed the 3rd strongest correlation with hemoglobin A1c.

본 연구는 제2형 당뇨병 환자가 인식하고 있는 구강건강 문제를 파악하고, 당화혈색소와 주관적 구강건강상태와의 연관성을 제시함으로써 당뇨병 환자의 전신 및 구강건강증진을 위한 기초자료를 제시하고자 시행하였다. 2012년 1월 9일부터 2012년 3월 9일까지 만 40세 이상 제2형 당뇨병을 가진 환자 174명에게 설문지 조사와 $In2it^{TM}$을 이용하여 당화혈색소를 측정한 결과 다음과 같은 결론을 얻었다. 1. 연구대상자의 구강건강문제를 파악한 결과 구강점막질환 증상 중 '입 안 점막에 염증이 있다'와 '입 안 점막이 아프다', 치주질환 증상 중 '칫솔질 시 잇몸에서 피가 난다', 구강건조증 증상 중 '평상시 내 입 안은 마른다고 느낀다'를 가장 많이 인식하는 것으로 나타났다. 2. 일반적 특성에 따라 주관적 구강건강상태를 분석한 결과, 특히 당뇨병 유병기간이 길수록 입안점막질환과 치주질환의 증상 및 구강건조증 증상을 더 많이 인식하는 것으로 나타났다(p<0.05). 3. 혈당 조절을 위한 건강행동에 따라 당화혈색소 수준을 분석한 결과, 규칙적인 식사를 잘 실천하는 집단에서 당화혈색소 수준이 더 낮은 것으로 나타났다(p<0.01). 4. 주관적 구강건강상태에 따라 당화혈색소 수준을 분석한 결과, '혀에 타는 듯한 느낌이 있다', '칫솔질 시 잇몸에서 피가 난다', '잇몸이 치아 뿌리 쪽으로 내려갔다' 및 '입에서 나쁜 냄새가 난다'를 인식한 집단에서 당화혈색소 수준이 더 높았다(p<0.05). 또한 구강건조증 증상 중 '나는 목이 말라 자다가 일어나 물을 마신다'에 응답한 집단에서 당화혈색소 수준이 더 높았다(p<0.05). 특히 다중선형회귀분석 결과 치주질환 증상은 당화혈색소와 3번째로 강한 연관성을 보인 요인으로 나타났다. 이상의 결과로 볼 때 혈당조절 정도는 다양한 구강건강문제와 관련성이 있으므로 당뇨병 환자를 대상으로 구강관리 프로그램의 적용을 더욱 강화하고, 의료인력의 협진을 통해 구강 내 당뇨합병증을 최대한 감소시켜야 할 것이다.

Keywords

References

  1. Harvard Medical School: Harvard medical school - family health guide. 1st ed. Dong-A Ilbo, Seoul, pp.828-829, 2004.
  2. Mealey BL, Ocampo GL: Diabetes mellitus and periodontal disease. Periodontol 2000 44: 127-153, 2007. https://doi.org/10.1111/j.1600-0757.2006.00193.x
  3. Korean Diabetes Association: What is diabetes. Korean Diabetes Association, Seoul, 2011.
  4. Ministry of Health & Welfare, Centers for Disease Control& Prevention: Korea Health Statictics 2010: Korean national health and nutrition examination survey (knhanes V-1). Ministry of Health & Welfare, Seoul, 2010.
  5. Statistics Korea: 2010 Causes of death statistics. Statistics Korea, Seoul, 2010.
  6. Wilkins EM: Clinical practice of the dental hygienist. 9th ed. Lippincott Williams & Wilkins, Philadelphia, pp.1075-1082, 2001.
  7. Lamster IB, et al.: The relationship between oral health and diabetes mellitus. J Am Dent Assoc 139(suppl): 19s-24s, 2008.
  8. Loe H: Periodontal disease. The sixth complication of diabetes mellitus. Diabetes Care 16: 329-334, 1993.
  9. Murrah VA: Diabetes mellitus and associated oral manifestations: a review. J Oral Pathol 14: 271-281, 1985. https://doi.org/10.1111/j.1600-0714.1985.tb00494.x
  10. Kim HS: A clinical study on the periodontal status of the patient with diabetes mellitus. Unpublished master's thesis, Chosun University, Gwangju, 1992.
  11. Persson RE, et al.: Assessment of periodontal conditions and systemic disease in older subjects. J Clin Periodontol 30: 207-213, 2003. https://doi.org/10.1034/j.1600-051X.2003.00237.x
  12. Shlossman M, et al.: Type 2 diabetes mellitus and periodontal disease. J Am Dent Assoc 121: 532-536, 1990.
  13. Hintao J, et al.: Root surface and coronal caries in adults with type 2 diabetes mellitus. Community Dent Oral Epidemiol 35: 302-309, 2007. https://doi.org/10.1111/j.1600-0528.2007.00325.x
  14. Kiran M, et al.: The effect of improved periodontal health on metabolic control in type 2 diabetes mellitus. J Clin Periodontol 32: 266-272, 2005. https://doi.org/10.1111/j.1600-051X.2005.00658.x
  15. Karikoski A, Ilanne-Parikka P, Murtomaa H: Oral health promotion among adults with diabetes in Finland. Commmunity Dent Oral Epidemiol 31: 447-453, 2002.
  16. Grossi SG, et al.: Treatment of periodontal disease in diabetics reduces glycated hemoglobin. J Periodontol 68: 713-719, 1997. https://doi.org/10.1902/jop.1997.68.8.713
  17. Gilbert GH, et al.: The paradox of dental need in a population-based study of dentate adults. Med Care 41: 119-134, 2003. https://doi.org/10.1097/00005650-200301000-00014
  18. Lee MR, Choi JS: Relationship of self-perceived symptoms of periodontal disease to quality of life in adults. J Dent Hyg Sci 12: 115-121, 2012.
  19. Bergdahl M: Salivary flow and oral complaints in adult dental patients. Community Dent Oral Epidemiol 28: 59-66, 2000. https://doi.org/10.1034/j.1600-0528.2000.280108.x
  20. Ng SK, Leung WK: Oral health-related quality of life and periodontal status. Community Dent Oral Epidemiol 34: 114-122, 2006. https://doi.org/10.1111/j.1600-0528.2006.00267.x
  21. Thomson WM, Williams SM: Further testing of the xerostomia inventory. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 89: 46-50, 2000. https://doi.org/10.1016/S1079-2104(00)80013-X
  22. Lee NH: Self-efficacy and self-care behavior in elderly patients with diabetes mellitus. Unpublished master's thesis, Kwandong University, Gangneung, 2005.
  23. Horowitz JF: Exercise-induced alterations in muscle lipid metabolism improve insulin sensitivity. Exerc Sport Sci Rev 35: 192-196, 2007. https://doi.org/10.1097/jes.0b013e318156e084
  24. Yu HJ, Song OG, Woo YM: Evaluation of dietary practice in diabetics by three-day food record. Diabetes Metab J 9: 278-279, 1985.
  25. Lee SJ: Self care behavior and associated factors in type II diabetes patients. Unpublished master's thesis, Chonbuk National University, Jeonju, 2011.
  26. Ostberg AL, et al.: Epidemiological dental indices and self-perceived oral health in adolescents: ecological aspects. Acta Odontol Scand 61: 19-24, 2003.
  27. Na HJ, Jung UJ: Oral care status and its related factor in diabetic patients. J Korean Soc Dent Hygiene 11: 81-94, 2011.
  28. Lagervall M, Jansson L, Bergstrom J: Systemic disorders in patients with periodontal disease. J Clin Periodontol l30: 293-299, 2003. https://doi.org/10.1034/j.1600-051X.2003.00325.x
  29. Kim HY: The relationship between diabetes mellitus and periodontitis: a review of major journals. Unpublished master's thesis, Chonnam National University, Gwangju, 2010.
  30. Airila-Mansson S, et al.: Self-reported oral problems, compared with clinical assessment in an epidemiological study. Int J Dent Hyg 5: 82-86, 2007. https://doi.org/10.1111/j.1601-5037.2007.00231.x
  31. Jung MH, Gwon MY, Kim YS: A study on the oral health and status in diabetic patients -based on data of 2006 national oral health survey-. J Dent Hyg Sci 9: 571-577, 2009.
  32. Kim KE, Han JH: The relationship between knowledge of oral health and actual condition on oral health care of diabetic patients. J Dent Hyg Sci 9: 345-351, 2009.
  33. Cockerham W, Sharp CK, Wilcox JA: Aging and perceived health status. J Gerontol 38: 349-355, 1983. https://doi.org/10.1093/geronj/38.3.349