Validation of guided questionnaire and its accuracy as a tool to initiate coordinated medical dental care on periodontal disease in children and adolescents with type-1 diabetes mellitus / Zaridah Zainal Abidin

Introduction: The bidirectional association between type 1 diabetes mellitus (T1DM) and inflammatory periodontal disease has been established, however the coordinated care between medical and dental are yet to be established. This thesis focuses on evaluating the GQ validity and accuracy as a tool to initiate coordinated medical dental care on periodontal disease in T1DM children and adolescent. Objectives: This study aimed to compare the accuracy of the GQ on self-screening of periodontal vs periodontal examination as initial tool among T1DM patients at the Paediatric Endocrine Clinic, to explore the perceived level of knowledge and perception of T1 DM patients and/or parents on PDs and its associating factor(s) and to measure the prevalence of PDs in T1DM children and adolescents and its associating factor(s) at two clinical centres from the periodontal examination. M ethodology: This cross- sectional study was carried out at Universiti Teknologi MARA and Universiti Malaya. T1DM patients under 18 years old were invited. Structured interviews were carried out to evaluate the participants’ self-perceived periodontal health status. Periodontal health parameters, including plaque index (PI), gingival index (GI), probing pocket depth (PPD), basic periodontal examination (BPE), and clinical attachment loss (CAL) were recorded during the clinical examination. Statistical analysis was performed to evaluate the sensitivity of the questionnaire and the relationship between T1DM and periodontal parameters. Result: A total of 113 T1DM patients participated in this study but only 109 completed both the interview and clinical examination. The acceptable accuracy of GQ is 68.8. 55 (48.7%) have healthy gingiva, and 54 (47.8%) have gingivitis. PD was found to be statistically significant: 1) in the group age of 13-18 T1DM patients (p- value = 0.048), 2) associated with the duration of T1DM (p-value = 0.018), bleeding symptoms (p value < 0.001). Poor knowledge was observed in parents and/or T1DM patients (p-value=0.007). Despite having a good perception of their periodontal health status, clinical parameters examined revealed otherwise. There is a statistically significant association between periodontal disease and uncontrolled HbAlc (p-value= 0.0018). Conclusion: GQ can be used as a self-screening tool, as an initiation of medical dental coordinated pathway and could be used to instil awareness on how to improve the impact of their understanding of disease control.