Study of the Association of Diabetes Mellitus and Orodental Health in Rural Communities of Nigeria

Diabetes mellitus (DM) and oral health have been reported to be linked, and showed a steady rise in prevalences. Despite evidence for the bi-directional relationship of these diseases, data to substantiate the association in Nigeria are lacking. Hence, it is necessary to study the prevalences of DM and orodental diseases; and their relationship as well as ascertaining the feasibility of opportunistic screening of DM during dental visits. First, a literature review of epidemiological and clinical studies was undertaken and it highlighted co-morbidity of the diseases in Nigeria; suggesting evidence of association of DM and orodental diseases. The distribution of the co-morbidity was more in the geopolitical zone (South-South) of the study location compared to other geopolitical zones of the country. Second, population-based and dental clinic-based data were collected to validate the reported relationship of the diseases. Prevalences of hyperglycaemia in Ndokwa communities and the dental clinics were 56.8% and 63.4%, respectively. This is perhaps the first study on community-based and hospital-based prevalences of hyperglycaemia in orodental diseases in Nigeria. Overall, 43.5% of the participants had orodental disease indicator (ODI); and 19.5% of the dental clients had periodontal disease (PD). Co-morbidity of 24.3% of hyperglycaemia and ODI was observed. The highest prevalence of the association of hyperglycaemia and individual clinical orodental parameters was 64.1%, and the least was 21.3%. Findings of the study support evidence of the relationship between the DM and orodental diseases. This therefore indicates that, DM can be screened at dental clinics and vice versa. It also indicates that education programs on DM need to highlight oral health and vice versa. The novelty of this study is that it provides evidence for opportunistic screening of hyperglycaemia in oral health clinics in Nigeria, since screening of these conditions is currently not routinely carried out till overt symptoms present. This study stresses the need for early community DM screening, as it is cost-effective. The study reports a triangular relationship between metabolic syndrome (MetS) components and PD. It also reveals another triangular association between hyperglycaemia, liver enzymes and periodontitis. A family case report indicates that 55% of the family members of the concerned subject had preventable cardiovascular disease risk factors. The study also shows that large numbers of people are hyperglycaemic, and some may be living lifestyles that promote DM. Anthropometric indices were shown to be promising in diabetes prediction and will be useful DM screening tool in rural communities. Public health education remains a feasible approach to controlling the discussed diseases, especially in rural communities where low literacy and poverty are found.