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J Periodontol. 2012 Jul;83(7):856-63. doi: 10.1902/jop.2011.110416. Epub 2011 Dec 5.

Oral care practices and A1c among youth with type 1 and type 2 diabetes.

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  • 1Department of Epidemiology and Biostatistics, Arnold School of Public Health and Center for Research in Nutrition and Health Disparities, University of South Carolina, Columbia, South Carolina 29208, USA.



Periodontal treatment is associated with lower hemoglobin A1c in individuals with diabetes, but the relationship between oral hygiene practices and A1c among youth with diabetes is understudied.


This study evaluates the cross-sectional relationships among oral health habits, reported oral conditions, and A1c and control of diabetes among a subset of youth with diabetes enrolled in the SEARCH for Diabetes in Youth study in South Carolina. Oral hygiene practices were determined by questionnaire, and periodontal bone loss was defined as alveolar bone loss ≥3 mm on ≥1 permanent tooth site on preexisting bitewing radiographs. A1c was considered controlled if individuals were aged ≤6 years with A1c <8.5%; aged 7 to 11 years with A1c <8.0%; aged 12 to 18 years with A1c <7.5%; and aged ≥19 years with A1c <7.0%.


Among 155 participants, 68% brushed their teeth no less than once daily, 84% flossed, and 70% rinsed, respectively, less than once a week. Diabetes control was associated with toothbrushing (≥1 time daily [odds ratio (OR) = 3.10; 95% confidence interval (CI) = 1.26 to 7.62] and using mouthrinse at least once weekly (OR = 3.33; 95% CI = 1.30 to 8.54) after multivariate adjustment. Periodontal bone loss was three times more common among those with dry mouth (OR = 3.05; 95% CI = 1.07 to 8.70).


Clinicians should be aware that children with diabetes tend to have poor oral hygiene practices. Dry mouth may indicate periodontal bone loss in children with diabetes.

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