Association between Periodontal Pocket Depth and Thyroid Stimulating Hormone Levels in Diabetic Patients: A Comparison of Controlled versus Uncontrolled Glycemic Status

Background: Diabetic individuals often experience poor oral health, while periodontitis is one of its commonly observed complications, leading to tooth mobility and eventual tooth loss. The presence of comorbidities, such as hypothyroidism frequently observed in diabetic patients can further aggravate periodontal inflammation. Hypothyroidism has been linked to worsening periodontitis, making it essential to investigate the relationship between glycemic control, thyroid stimulating hormone (TSH) levels, and periodontal condition to address the requirement of early prevention and management. 
Objective: This research aimed to assess the periodontal health in association with thyroid function among diabetic patients with and without controlled glycemic status.
Methods: With a comparative cross sectional study design, this study was conducted in the out-patient department of Oral and Maxillofacial Surgery unit, Uttara Executive Center, Uttara, Dhaka for a period of 6 months from April to September, 2024. Association of TSH levels and periodontal pocket depth was assessed in groups of patients with a HbA1c level below 8% compared to a group of patients with a HbA1c level of 8% or above. The collected data were was analyzed using IBM SPSS Statistics version 25.
Result: This study represents a diabetic sample with mean age of 43.16 ± 12.37 years, comprising of 53.9% males and 46.1% females. Around 60% of the patients had HbA1c levels exceeding 8%, and 56% patients had TSH levels more than 4.5 mIU/L. Significant association between TSH levels and periodontal pocket depth was observed, which was stronger in patients with HbA1c levels above 8% (p=0.001)
Conclusion: This study observed high incidence of uncontrolled diabetes and a high prevalence of thyroid dysfunction among diabetic patients. The findings suggest that poor glycemic control worsens the impact of thyroid dysfunction on periodontal health. The combined effect of both conditions may aggravate periodontal issues, emphasizing the need for managing glycemic and thyroid levels to improve oral health outcomes in diabetic patients.