Adequacy of oral health information for patients with diabetes

The Relationship between Oral and Dental Health Self-care and Hemoglobin A1c in Adults with Diabetes

Statement of the Problem

Due to the mutual relationship between periodontal diseases and diabetes, it seems that adopting oral self-care in a way to prevent and control the progress of periodontal diseases, improves the oral health of diabetic patients as well as their general health.

Purpose

The aim of this study was to investigate the relationship between the oral self-care behaviors and the hemoglobin A1c (Hb A1c) levels in adults with diabetes.

Materials and Method

In this cross-sectional study with convenience sampling, 120 adults between 18 to 50 years old, who had at least two healthy functional teeth, were selected from private endocrinology offices in Tehran in August 2019. The exclusion criteria were illiterate individuals and pregnant women. A standard questionnaire was used which included the information about demographic, diabetes, and self-care behaviors. The outcome variable was the latest Hb A1c rate.

Results

The mean age of participants was 35.8±10.5 years. The average Hb A1c was 7.4± 1.55%. 35.0% of participants brushed their teeth twice a day or more and 60.8% flossed rarely. The proportion of Hb A1c <7% was higher in three groups including the participants who had information about the effect of periodontal disease on diabetes (p= 0.032), participants who brushed twice a day or more (p= 0 .014), and those who used dental floss once a day or more (p< 0.001). The likelihood of having Hb A1c <7% in participants who had information about the effect of periodontal disease on diabetes was about three times more than those who had no information (OR= 3.05, p= 0.036). Furthermore, it was about six times higher in participants who used dental floss once a day or more than those who used rarely (OR= 5.66, p= 0.001).

Conclusion

Results of the present study show that people who had better oral health self-care behaviors had better Hb A1c and diabetes control.

Oral health status and self- assessment of oral health risk factors among South Indian diabetic patients

Background

The disease profile of the world is changing at an astonishingly fast rate. It is essential that the impending nature of chronic disease is recognized and acted on urgently. India leads the world with the largest number of diabetics earning the dubious distinction of being termed the "diabetic capital" of the world.

Aim

To assess and compare the oral health status and related oral health risk factors among diabetic patients in Hyderabad and Secunderabad.

Settings

A cross sectional study was carried out in various diagnostic centers among 801 patients aged 30 years and above.

Methods and Materials

Oral health status and self-assessed data on related oral risk factors were measured using modified World Health Organization (WHO) assessment form and oral health questionnaire for adults 2013.

Statistical Analysis

Comparison of mean scores of the variables based on gender was assessed using ANOVA. Statistical significance was set at p < 0.05.

Results

Females had higher proportion of untreated caries (362; 85%) and DMFT (Decayed, Missing and Filled Teeth; 375; 88%) compared to males. On the basis of loss of attachment, the mean number of sextants with no loss of attachment was mostly noted among female subjects.

Conclusion

In the present study, though gingivitis was seen in higher percentage (82%), the presence of periodontal disease was relatively low (68.3%). It can be concluded that diabetic subjects may have poor oral health.

Perspectives of diabetes educators and dental hygienists regarding strategies to improve oral health for people with diabetes

AIMS

This study aims to explore the opinions of dental hygienists and diabetes educators on improving oral health for people with diabetes.

METHODS

Registered dental hygienists (RDHs) and certified diabetes educators (CDEs) who provided written responses to the same open-ended question from two state-wide mailing surveys (one for RDHs and the other for CDEs) "what more can you tell us to help improve oral health for people with diabetes?" were included in this study. The surveys were sent to all RDHs (n=2237) and CDEs (n=250) in the state of South Carolina, United States.

RESULTS

Of the 1125 valid returned questionnaires from both surveys, 474 provided written responses to this question. Qualitative analysis revealed three main themes from participants' written responses which were: Education (3 subthemes: resources for patients, educate the public, and professional practice resources), interprofessional collaborative care (3 subthemes: role of medical and dental professionals in oral health promotion for people with diabetes, and role of dental and diabetes professional organizations, and companies in the oral healthcare industry), and dental insurance.

CONCLUSIONS

The three themes that emerged are interrelated indicating that strategies to improve oral health for people with diabetes are multi-faceted.

Association between oral health-related quality of life and general health among dental patients: a cross-sectional study

Globally, the prevalence of chronic diseases is increasing significantly, causing deterioration of oral and general health and therefore quality of life. The present study was designed to assess the relationship between oral health-related quality of life and general health of dental patients. The study is part of the University's plan to achieve the United Nations Sustainable Development Goals number 1, 3, 4 and 5. Dental school students' satisfaction with their early engagement in clinical activities and research work was also evaluated. A convenience sample of 600 subjects attending dental clinics aged ≥18 years of both sexes was included in the study. Second-year dental students conducted the study under the supervision of public health staff members over two successive academic years (2015-2016 and 2016-2017). Oral health-related quality of life was assessed using the Dental Impact on Daily Living (DIDL) questionnaire. Blood pressure, random blood glucose level, body mass index, and waist circumference were measured as indicators of general health. There were statistically significant inverse correlations between DIDL scores and both mean blood pressure (r = -0.215, p < 0.001) and mean blood glucose level (r = -0.272, p < 0.001). Non-significant inverse correlations were observed between DIDL scores and both body mass index (r = -0.062, p = 0.131) and waist circumference (r = -0.040, p = 0.340). Students' satisfaction scores with research activities were high, ranging from 75.9% to 78%. Dentists must raise patients' awareness about the importance of oral health and its impact on their quality of life and general health. Participation of dental students in dental research is encouraged even in their early academic years.

Assessment of oral hygiene trends among dental patients in relation to chronic medical conditions by dental students. A cross-sectional study

INTRODUCTION

There is a lack of information about knowledge, attitude and behavior regarding oral hygiene and dietary habits of adult patients attending dental clinical settings. Hypertension, diabetes, obesity and caries are increasing among different populations, resulting in the deterioration of the quality of life related to oral and general health.

OBJECTIVES

To involve second year dental students in assessing oral health knowledge, attitude, behavior, dietary habits and general health of dental patients, and screening for blood pressure, blood glucose level and obesity.

PARTICIPANTS AND METHODS

A convenient sample of 652 adult subjects participated in the study. They were screened, and involved in an interviewer - led questionnaire, led by the students over the period of two successive academic years (2013-2014 and 2014-2015).

RESULTS

Subjects with high blood pressure and /or blood glucose levels were more likely to disagree regarding the presence of a relation between general health and dental health [(correlation coefficient (r) = - 0.159, probability value P < 0.001) (correlation coefficient (r) = - 0.257, probability value P < 0.001) respectively]. Subjects with high BMI were less aware of the importance of using the tooth brush in prevention of gingival inflammation. The overall students' satisfaction score was 71.5%. The practical part of the research had the highest satisfaction score (83.7%).

CONCLUSIONS

There is scarcity of data regarding dental healthcare knowledge and attitudes in dental clinical settings. Additional clinical training for dental students would increase their willingness to play a preventive and educational role in the oral care of patients.

Factors associated with additional time dental hygienists spent on educating patients with diabetes

AIMS

To investigate what dental hygienists' practice characteristics and oral health topics are associated with additional time dental hygienists spent on educating patients with diabetes.

METHODS

A one-page survey was mailed to 2237 registered dental hygienists in South Carolina. Survey questions focused on perceptions of dental hygienists regarding their oral health preventive education for patients with diabetes. After two follow-up mails, we received 995 usable questionnaires.

RESULTS

Multivariable logistic regression modeling showed dental hygienist respondents who spent additional time educating patients with diabetes about oral health felt they had adequately covered the topics on effects of periodontal disease related to diabetes, effects of uncontrolled diabetes on periodontal disease, and nutrition and dietary counseling. In addition, a higher number of patients with diabetes treated per week, and a shorter recall interval for patients were also associated with more likelihood of respondents spending additional time educating patients with diabetes.

CONCLUSION

Results suggest that the additional time that dental hygienist respondents spent on educating patients with diabetes was related to oral health issues associated with diabetes, not just repetition of routine oral hygiene and plaque control instructions.

Awareness of oral complications and oral hygiene habits of subjects with diagnosed Diabetes Mellitus

Background/Aim: The aim was to evaluate Diabetes Mellitus (DM) patients' awareness of their risk for oral and dental complications, to evaluate their oral health behaviors, assess their sources of related information, and to detect the influence of their awareness on oral health and dental management. Material and Methods: Total of 240 DM patients presenting to a university outpatient dental facility for routine care completed a self-administered questionnaire about demographic socioeconomic characteristics, oral health care and awareness on oral complications of DM. Dental status of each patient was recorded. Data were analyzed with Chi- square test; p was set as 0.05. Results: The patients' mean age was 52.85 years; the majority had Type 2 DM (72.1%) and 61.7% were females. Two thirds of the patients had tooth loss; 65% brushed daily and used toothpick for interproximal cleaning (35%). Only 12.9% had regular dental visits and 37.5% reported their oral health as 'poor'. DM patients rarely received guidance from their health care professionals regarding their oral health (28.3%). Even though 62.5% were aware of oral complications of DM, only 46.3% knew that oral health may affect DM. The patients with Type 1 and Type 2 DM had similar perceptions about their oral health status (p=0.15>0.05). However, insulin users were more aware of the interaction between oral health and DM (p>0.05), and were more likely to consider their oral health as 'poor' (p>0.05). Conclusions: DM patients' awareness of the effect of DM on oral health was higher than that of the effect of oral health on DM management. Medical health care providers were failing to provide the necessary information regarding these issues when compared to dentists.

Knowledge, awareness, and behaviors of endocrinologists and dentists for the relationship between diabetes and periodontitis

AIMS

This study aimed to compare the opinions of dentists and endocrinologists regarding diabetes mellitus (DM) and periodontitis, and to investigate the possible effects on their practice.

METHODS

Cross-sectional data were collected from 297 endocrinologists and 134 dentists practicing in southern China using two separated questionnaires. Questions were close-ended or Likert-scaled. Statistical analyses were done by descriptive statistics, bivariate and binary logistic regression analysis.

RESULTS

Compared with endocrinologists, dentists presented more favorable attitudes for the relationship of DM and periodontitis (P<0.001). 61.2% of dentists reported they would frequently refer patients with severe periodontitis for DM evaluation, while only 26.6% of endocrinologists reported they would frequently advise patients with DM to visit a dentist. Nearly all of the respondents (94.4%) agreed that the interdisciplinary collaboration should be strengthened. The logistic regression analysis exhibited that respondents with more favorable attitudes were more likely to advise a dental visit (P=0.003) or to screen for DM (P=0.006).

CONCLUSIONS

Endocrinologists and dentists are not equally equipped with the knowledge about the relationship between DM and periodontitis, and there is a wide gap between their practice and the current evidence, especially for endocrinologists. It's urgent to take measures to develop the interdisciplinary education and collaboration among the health care providers.

Association between seeking oral health information online and knowledge in adults with spinal cord injury: a pilot study

OBJECTIVE

To characterize adults with spinal cord injury (SCI) who seek oral health information online, and investigate whether seeking oral health information online is associated with oral health knowledge and behaviors.

METHODS

An online oral health survey was posted on the South Carolina Spinal Cord Injury Association website. Respondents were 192 adult residents of the US ages 19-83 years who identified themselves as having SCI occurring at least 1 year before the survey date.

RESULTS

About 12% (n=23) of the respondents searched oral health information online in the past 12 months. Significant associations between the proportion of respondents who searched for oral health information online and socio-demographic and the proportion of respondents who engaged in various oral health behaviors were not detected. However, multivariable logistic regression indicated that respondents who searched oral health information online in the past 12 months have 3.4 times the odds of possessing adequate oral health knowledge compared to respondents who did not search oral health information online (adjusted odds ratio=3.41, 95% confidence interval = 1.35, 8.62, P=0.01).

CONCLUSIONS

Given the significant association between seeking oral health information online and adequate oral health knowledge, this study suggests that online oral health information may be a potential avenue for dental health professionals to supplement oral health education in adults with SCI.