Are diabetes and dental care providers in the Republic of Mauritius advising patients about the importance of oral health in diabetes management?

Dental referrals for patients with diabetes: survey of barriers and enablers for medical and health professionals

BACKGROUND

Oral health care improves diabetes management; however, medical and other health practitioners do not commonly refer their patients with diabetes for oral health care. This study aimed to understand barriers to and enablers of dental referrals for patients with diabetes.

METHODS

Quantitative data were collected from a cross-sectional survey of health care providers attending a virtual Grand Rounds on the relationship between oral health and diabetes. Attendees were invited to complete and share a Forms survey. Barriers to and enablers of dental referrals were compared for 18 health professionals working in inpatient/ward settings to 23 working in community/primary care settings using the chi-square test.

RESULTS

Across both work settings, only 12% of respondents often or always discussed the importance of oral health and only 8% often or always referred their patients with diabetes for dental care. Time barriers, awareness and knowledge of how/where to send dental referrals were significant barriers, while online referral pathways, more education and availability of brochures for the patient to take home were identified as key enablers for dental referrals.

CONCLUSIONS

Online referral pathways, targeted oral health education and resources for medical and health professionals caring for patients with diabetes may increase the number of patients being referred for dental care as part of their diabetes managements. © 2023 Australian Dental Association.

Oral health and type 2 diabetes in a socioeconomic perspective

AIMS

This study aimed to examine the association between type 2 diabetes and poor self-rated oral health, and to investigate whether such association is modified by socioeconomic position.

METHODS

We conducted a cross-sectional study, including a population aged 18-75 years with self-reported type 2 diabetes (N = 41,884) and a sex-, age- and municipality-matched reference population from the Health in Central Denmark survey (2020). Multivariable logistic regression was used, and effect modification of indicators of socioeconomic position was examined.

RESULTS

Oral health was rated as poor in 37.0% of the population with type 2 diabetes and in 23.8% of the reference population without diabetes. Individuals with diabetes had higher risk of poor oral health (adjusted odds ratio (OR) 1.46 (95% CI: 1.39; 1.53)) than references. Interaction was seen between type 2 diabetes and highest attained education (p < 0.001). Stratified analyses showed higher risk of poor oral health in people with type 2 diabetes across all educational levels.

CONCLUSIONS

People with type 2 diabetes were more likely to rate their oral health as poor than the reference population. Low education strengthened the association between diabetes and poor oral health.

Impact of diabetes diagnosis on dental care utilization: evidence from Finland

BACKGROUND

Poor oral health is associated with many chronic diseases, including diabetes. As diabetes can worsen oral health and vice versa, care guidelines recommend that patients with diabetes maintain good oral health and have regular dental checkups. We analyzed the impact of receiving an initial type 2 diabetes diagnosis on dental care utilization.

METHODS

We used register data on residents aged over 25 in the city of Oulu, Finland, covering the years 2013-2018. We used the difference-in-differences method and individuals with no diabetes diagnosis as control group. As robustness checks, we used propensity score matching and constructed an alternative control group from patients that received the same diagnosis a few years apart.

RESULTS

Despite the guideline recommendations, we found that receiving a diabetes diagnosis did not increase the probability for dental care visits in a two-year follow-up. The findings remained similar for both high-income and low-income persons.

CONCLUSIONS

The finding is concerning in terms of diabetes management and oral health. Further research is needed on the reasons behind the lack of response to guidelines.

Indicators of integrating oral health care within universal health coverage and general health care in low-, middle-, and high-income countries: a scoping review

BACKGROUND

The World Health Organization (WHO) has recently devoted special attention to oral health and oral health care recommending the latter becoming part of universal health coverage (UHC) so as to reduce oral health inequalities across the globe. In this context, as countries consider acting on this recommendation, it is essential to develop a monitoring framework to measure the progress of integrating oral health/health care into UHC. This study aimed to identify existing measures in the literature that could be used to indicate oral health/health care integration within UHC across a range of low-, middle- and high-income countries.

METHODS

A scoping review was conducted by searching MEDLINE via Ovid, CINAHL, and Ovid Global Health databases. There were no quality or publication date restrictions in the search strategy. An initial search by an academic librarian was followed by the independent reviewing of all identified articles by two authors for inclusion or exclusion based on the relevance of the work in the articles to the review topic. The included articles were all published in English. Articles concerning which the reviewers disagreed on inclusion or exclusion were reviewed by a third author, and subsequent discussion resulted in agreement on which articles were to be included and excluded. The included articles were reviewed to identify relevant indicators and the results were descriptively mapped using a simple frequency count of the indicators.

RESULTS

The 83 included articles included work from a wide range of 32 countries and were published between 1995 and 2021. The review identified 54 indicators divided into 15 categories. The most frequently reported indicators were in the following categories: dental service utilization, oral health status, cost/service/population coverage, finances, health facility access, and workforce and human resources. This study was limited by the databases searched and the use of English-language publications only.

CONCLUSIONS

This scoping review identified 54 indicators in a wide range of 15 categories of indicators that have the potential to be used to evaluate the integration of oral health/health care into UHC across a wide range of countries.

Oral Health Behaviour and Predictors of Oral Health Behaviour Among Patients With Diabetes in the Republic of Mauritius

OBJECTIVES

To investigate the oral care habits and assess the determinants of oral care behaviour among people with diabetes in the Republic of Mauritius.

METHODS

The present study draws on data collected from 589 dentate persons with diabetes by means of a close-ended questionnaire. Multivariate logistic regression analyses were used to estimate the association of different demographic and clinical factors with recommended dental hygiene practices.

RESULTS

The majority of the participants brushed at least twice daily (84.2%), never flossed (88.6%), attended dental clinics on need only (87.1%), and did not monitor their blood glucose levels regularly (69.9%). Neither awareness about the increased risk of periodontal disease and xerostomia nor receiving advice from diabetes care providers was found to be associated with good oral hygiene or increased service utilisation. The experience of oral diseases did not encourage recommended oral health practice, with participants without experience with periodontal disease being 3 times more likely to floss (odds ratio [OR], 2.9; P = .045). Regular dental visits were strongly associated with self-reported type 1 diabetes (OR, 7.8; P = .025). Participants from urban areas were more than twice as likely to visit their dental care provider at least once annually (OR, 2.3; P = .006). Regular dental attendance (OR, 3.7; P = .011) and flossing (OR, 4.5; P = .012) were strongly associated with one another.

CONCLUSION

There is widespread noncompliance with regular flossing and dental service utilisation. Our findings highlight the need for an emphasis on preventive care through the provision of integrated medical and dental interventions to high-risk individuals suffering from both diabetes and chronic periodontitis.

Relation between Activator Factors and Compliance Behavior of Using Personal Protective Equipment on Technician Workers at PT ARPS Surabaya

Introduction: Equipment that must be used by workers for work safety when working with potential work hazards or accidents is personal protective equipment (PPE). The purpose of this study was to analyze the factors associated with the use of PPE in the workforce of technicians at PT. APRS in terms of PPE usage. Methods: This research was an analytic observational study, with cross sectional design. The subjects of this study were all of the technician workforce in the section of Blow molding, Maintenance and Injection Molding unit, totalling 39 respondents. Results: This study showed that activator factors such as perception (r = 0.108), knowledge of occupational health and safety (r = -0.104), and PPE regulation (r = -0.166) had a weak relationship with safety behavior on compliance with PPE implementation. Conclusions: The workforce behaved poorly in using PPE in the workplace. In the Blow Molding, Maintenance and Injection Molding unit, workers who had a moderate level of perceptions, workers who had a moderate level of knowledge, and workers who had a enough ability to comply with PPE regulations.Keywords: knowledge, perception, personal protective equipment, policy

Needs Assessment Towards Development of an Integrated Diabetes-Oral Health Nutrition Education Module: A Qualitative Study

INTRODUCTION

The diabetes mellitus-periodontitis relationship has advocated several strategic management approaches on effective glycaemic control and oral health improvement for diabetic patients and periodontitis patients with diabetes. We aimed to identify the challenges of providing health education to patients with diabetes and/or periodontitis among healthcare professionals and needs for an integrated nutrition-oral health education module.

METHODS

This study involved semi-structure in-depth interview with fifteen healthcare professionals from a training hospital focused on: (i) the existing issues and challenges encountered while managing patients for their nutrition and care and (ii) issues related to the current practice among healthcare professionals. Details pertaining to the participants' verbal and non-verbal responses were recorded, transcribed ad verbatim and analysed using themes codes.

RESULTS

Patients' attitude and behaviour, language barriers and prioritising time were found as the common problems with patients, while limited knowledge on the relationship between diabetes-periodontitis, limited availability of appropriate and cultural-based health educational tools, lack of inter-professional multidisciplinary collaboration in managing patients, and constrains in time as well as costly therapy were common issues in the current practice.

CONCLUSIONS

Cost-effective efforts must be focused on overcoming these issues besides emphasizing the needs on developing an integrated module to achieve better management outcomes.