Periodontal health status and implication of periodic acid–Schiff diastase - a key in exfoliative cytology among diabetics mellitus patients: A case–control study

OBJECTIVES: The objectives of the study are: (i) To determine if periodic acid–Schiff (PAS)-Diastase is an effective tool to diagnose DM noninvasively, (ii) to use three different types of staining procedures to identify the staining pattern over the exfoliated cells of normal and diabetic patients, (iii) to study the periodontal health status of DM and normal subjects. MATERIALS AND METHODS: Basic questions regarding the demographic data were asked, following which community periodontal index (CPI) was recorded. Oral smears were collected from clinically normal buccal mucosa of 150 patients using wooden tongue spatulas. The subjects were asked to gargle their mouth with water and the wooden spatula was scraped at the site from buccal mucosa. The smears were spread evenly on a dry clean glass slide and fixed immediately with absolute ethyl alcohol. Three slides were prepared for each of the patients. PAS, PAS with diastase digestion, and Papanicolaou staining were performed and examined under a microscope. RESULTS: Average CPI for study subjects was 3.2 and control subjects was 2.1. The average loss of attachment was 1.1 in the study group and 0.2 in the control group (P - 0.00) and the result are statistically highly significant. All the 150 cases (100%) were positive for PAS staining, while PAS-diastase (PAS-D) staining showed positivity only for normal subjects and was negative (100%) in the diabetic group (P - 0.00) and the result are statistically highly significant. CONCLUSIONS: Results of our study showed that exfoliative cytology of the oral cavity, when stained with PAS and PAS-D, can be used as an effective screening and diagnostic tool for DM patients.