Systematic review of studies examining contribution of oral health variables to risk prediction models for undiagnosed Type 2 diabetes and prediabetes

Authors

Ingrid Glurich, Center for Oral and Systemic Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA.
Neel Shimpi, Center for Oral and Systemic Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA.
Barb Bartkowiak, Marshfield Clinic GE Magnin Medical Library, Marshfield Clinic Health System, Marshfield, Wisconsin, USA.
Richard L. Berg, Office of Research Computing and Analytics, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA.Follow
Amit Acharya, Advocate Aurora HealthFollow

Recommended Citation

Glurich I, Shimpi N, Bartkowiak B, Berg RL, Acharya A. Systematic review of studies examining contribution of oral health variables to risk prediction models for undiagnosed Type 2 diabetes and prediabetes. Clin Exp Dent Res. 2022;8(1):96-107. doi:10.1002/cre2.515

Affiliations

Advocate Aurora Research Institute

Abstract

Objective: To conduct systematic review applying "preferred reporting items for systematic reviews and meta-analyses statement" and "prediction model risk of assessment bias tool" to studies examining the performance of predictive models incorporating oral health-related variables as candidate predictors for projecting undiagnosed diabetes mellitus (Type 2)/prediabetes risk.

Materials and methods: Literature searches undertaken in PubMed, Web of Science, and Gray literature identified eligible studies published between January 1, 1980 and July 31, 2018. Systematically reviewed studies met inclusion criteria if studies applied multivariable regression modeling or informatics approaches to risk prediction for undiagnosed diabetes/prediabetes, and included dental/oral health-related variables modeled either independently, or in combination with other risk variables.

Results: Eligibility for systematic review was determined for seven of the 71 studies screened. Nineteen dental/oral health-related variables were examined across studies. "Periodontal pocket depth" and/or "missing teeth" were oral health variables consistently retained as predictive variables in models across all systematically reviewed studies. Strong performance metrics were reported for derived models by all systematically reviewed studies. The predictive power of independently modeled oral health variables was marginally amplified when modeled with point-of-care biological glycemic measures in dental settings. Meta-analysis was precluded due to high inter-study variability in study design and population diversity.

Conclusions: Predictive modeling consistently supported "periodontal measures" and "missing teeth" as candidate variables for predicting undiagnosed diabetes/prediabetes. Validation of predictive risk modeling for undiagnosed diabetes/prediabetes across diverse populations will test the feasibility of translating such models into clinical practice settings as noninvasive screening tools for identifying at-risk individuals following demonstration of model validity within the defined population.

Document Type

Article

PubMed ID

34850592