Introduction

Periodontal disease remains one of the most reported oral health conditions associated with diabetes and other systemic diseases, such as HIV infection and cardiovascular diseases, among others globally [1,2]. Current research studies have shown a steady increase in the prevalence and severity of periodontal disease among diabetic compared to non-diabetic patients [3,4]. Studies have continued to document a bidirectional relationship between periodontal disease and diabetes. Evidence shows that diabetes increases the prevalence, extent, and severity of periodontitis, and periodontitis negatively affects glycemic control, thus worsening the symptoms of diabetes [5,6].

In a review paper exploring this bidirectional relationship, it was revealed that the risk of developing periodontitis was two to three times higher in people with diabetes compared to individuals without. In the same paper, it was also found that treatment of periodontitis among people with diabetes resulted in improved glycemic control, with HbA1c reductions of 3-4 mmol/mol (0.3-0.4%) within three to four months after treatment [7]. On the other hand, a meta-analysis published in 2023 established that diabetes augmented the likelihood of developing or progressing into periodontitis by 86% [8]. Even with such a well-documented relationship between periodontal disease and diabetes, the prevalence of periodontitis remains scanty in Uganda. Only one research study attempted to determine the prevalence of periodontal disease among diabetes mellitus patients in Uganda. In this study, a prevalence of 85% of periodontal disease among diabetes mellitus patients was reported [9].

Data from epidemiological studies show that periodontal disease has been associated with increasing age, male gender, a low level of education, frequency of tooth brushing, frequency of dental clinic visits, poor oral hygiene, smoking, and presence of comorbidities [10,11]. However, very few studies focus on periodontal disease risk factors among diabetic patients. In Uganda, these associations remain unknown. Only a low level of education was found to be statistically significant for periodontal disease among diabetics after adjustment [9]. Therefore, this study determined the prevalence and associated factors of periodontal disease among patients attending a diabetic clinic in a referral hospital in rural southwestern Uganda.