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The prevalence of potentially undiagnosed type II diabetes in patients with chronic periodontitis attending a general dental practice in London - a feasibility study

British Dental Journal volume 231, pages 180–186 (2021)Cite this article

Abstract

Introduction In the UK alone, it is estimated that one in four people with type II diabetes are currently undiagnosed.

Aim To investigate the prevalence of potentially undiagnosed type II diabetes in patients with chronic periodontitis attending a general dental practice in North London.

Methods Patients aged 35 years and over, who had not been diagnosed with diabetes, attending for routine examination and diagnosed with chronic periodontitis, were offered screening for diabetes risk using the self-reporting Finnish Diabetes Risk Score (FINDRISC) questionnaire. If the score showed an increased risk of developing type II diabetes, a referral letter was sent to their general medical practitioner (GMP) for formal testing. The uptake and results of the test were recorded.

Results Over the 12-month period, a total of 51 patients were eligible to take part, with 40 agreeing to participate (78% participation rate). Nineteen participants (48%) were found to be at a significantly increased risk of developing type II diabetes based on the recommended FINDRISC cut-off point and were referred to their GMP for formal testing. Eleven participants (58%) scored above the FINDRISC cut-off point and were categorised as high-risk. A further six participants (32%) fell into the moderate-risk category and two participants (10%) fell into the slightly elevated-risk category. Of the 19 participants who were referred for formal testing, four were not found to have type II diabetes, nine were found to have intermediate hyperglycaemia (or prediabetes) and two participants were diagnosed with type II diabetes.

Conclusions This study confirmed a method of diabetes risk screening that has a good rate of uptake by patients and is practical for use in general dental practice. A moderate proportion of patients were identified as having an increased risk of developing diabetes and just under half were referred for formal testing. The study has shown an effective method for identifying undiagnosed type II diabetes and prediabetes in patients diagnosed with periodontitis who attend general dental practice.

Key points

  • This is one of the few studies of screening for systemic disease conducted in a general dental practice setting.

  • The screening method used is an effective and accepted way to identify undiagnosed type II diabetes risk.

  • The prevalence of undiagnosed type II diabetes within the population sample was 5% and the prevalence of prediabetes was 23%.

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Acknowledgements

This study was self-funded and was performed by the first author as part of an MSc programme run by the University of Kent. Thanks are given to the first author's practice principal for his permission to perform the study in his practice and to the patients who agreed to participate.

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Authors and Affiliations

  1. General Dental Practitioner, Fladbury Dental Surgery, 15 Fladbury Road, London, N15 6SB, UK

    Gavin Goh

  2. Retired Specialist Practitioner, Briars Dental Centre, 8 St John’s Road, Newbury, Berkshire, RG14 7LJ, UK

    Philip Ower

  3. Honorary Professor, Centre for Professional Practice, Medway Building, University of Kent, Chatham Maritime, Kent, ME4 4AG, UK

    Kenneth Eaton

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  1. Gavin Goh
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  2. Philip Ower
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Contributions

G.G. designed the study, collected the data, wrote the first draft of the manuscript and agreed its final version. P.O. supervised the study and the MSc dissertation based on the study, reviewed drafts of the manuscript and agreed its final version. K.E. advised on the design of the study, monitored its progress, edited all drafts of the manuscript and agreed its final version.

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Correspondence to Gavin Goh.

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None of the authors are aware of any conflict of interest.

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Goh, G., Ower, P. & Eaton, K. The prevalence of potentially undiagnosed type II diabetes in patients with chronic periodontitis attending a general dental practice in London - a feasibility study. Br Dent J 231, 180–186 (2021). https://doi.org/10.1038/s41415-021-3223-5

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