Background The relationship between uncontrolled type-2 diabetes mellitus (T2DM) and periodontitis have been investigated among people from different nations. But, the current report is first from Saudi Arabia that utilized the gold standard measures to study the effect of uncontrolled T2DM on the periodontal status of ethnically similar Arab adults. Methods A case-control study was conducted, wherein cases were adults with clinically diagnosed periodontitis (clinical-attachment-loss ≥ 1 mm).

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... ncurrent controls were recruited from the same dental facility; matched with age, sex, and location. Uncontrolled T2DM was recorded using HbA1c readings; and other health conditions including hypertension, epilepsy, bronchitis, thyroid disorders, and arthritis were retrieved from the participant's medical records. Data on tobacco consumption and related products (smoking, khat/qat, sheesha, shammah) was gathered using a self-perceived questionnaire. Frequencies, percentages, p-values, crude and adjusted odds ratios (OR) with 95% confidence intervals were computed. Results Overall sample comprised of 166 cases and 332 controls with a mean age of 37.5 years. Multivariate analysis indicated uncontrolled T2DM as an important predictor for periodontitis among Saudi Arabian adults, and they had nearly three times greater odds (OR: 2.779; 95% CI: 1.425–5.419; p = 0.003) of being diagnosed with periodontitis in contrast to non-diabetics. Secondary findings revealed that cigarette ever-users were 2 times more likely to be suffering from periodontitis than never-users, and those brushing once per day or less had 5 times greater odds of developing periodontitis as compared to those brushing twice daily. Conclusion To conclude, the current case-control study is the first from Saudi Arabia to indicate that increased HbA1c level significantly effects periodontal status of Arab adults. An awareness of this association among health care providers and patients will contribute towards prevention of periodontitis in Saudi Arabia.