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Aldosari M, Archer HR, Almutairi FT, Alzuhair SH, Aldosari MA, Kennedy E. Utilization of dental care and dentate status in diabetic and nondiabetic patients across US states: An analysis using the 2020 Behavioral Risk Factor Surveillance System. J Public Health Dent 2024; 84:187-197. [PMID: 38599647 DOI: 10.1111/jphd.12613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 02/15/2024] [Accepted: 03/08/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE This study examines the differences, by state, in dental care utilization and tooth retention between adults with and without diabetes mellitus (DM). METHODS We conducted a secondary analysis of data from the 2020 Behavioral Risk Factor Surveillance System, an annual, state-based, random telephone survey of noninstitutionalized US civilian adults. The predictor variable was DM status. The outcome variables were time since the last dental appointment and tooth loss. We utilized multiple multinomial logistic regression models followed by postestimation procedures to determine state-level adjusted proportions for dental visits within the last year and complete teeth retention among DM and non-DM adults. RESULTS Among adults with DM, 60.0% reported dentist visits within a year of survey participation, while 53.6% had complete tooth retention. As education and income levels increased, dental attendance and tooth retention increased among adults with DM. Most Southern states had a higher prevalence of DM, a lower proportion of dentist visits, and worse tooth retention among DM adults. Nationally, DM individuals were 4.3 percentage points less likely to visit a dentist and were 7 percent less likely to have complete teeth retention than non-DM adults. Compared with the national average, 25/50 states had greater disparities in dental visits between DM and non-DM adults, and 27/50 states had greater disparities in tooth loss between DM and non-DM adults. CONCLUSION State-level variations indicate geographical and dental coverage influences on DM and dental outcomes. There is a need for state-specific interventions to improve dental access and outcomes for adults with DM.
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Affiliation(s)
- Muath Aldosari
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA
| | - Hannah R Archer
- Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Saud H Alzuhair
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - Erinne Kennedy
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- College of Dental Medicine, Kansas City University, Joplin, Missouri, USA
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Hessain D, Andersen A, Fredslund EK. Inequalities in healthcare utilisation among adults with type 2 diabetes. Diabetes Res Clin Pract 2023; 205:110982. [PMID: 37890705 DOI: 10.1016/j.diabres.2023.110982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/11/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
AIMS To examine inequality in dentist, ophthalmologist, and podiatrist attendance among adults with type 2 diabetes in a country with varying degrees of co-payment. RESEARCH DESIGN AND METHODS We conducted a cross-sectional study with a population of 41,181 people with type 2 diabetes resident in the Central Denmark Region in 2019, identified through Danish registers using a prespecified diabetes algorithm. Descriptive statistics and multiple logistic regression were used to examine the attendance at dentist, ophthalmologist, and podiatrist, controlling for sociodemographic and clinical factors. Attendance at dentist, ophthalmologist, and podiatrist were examined separately. RESULTS The majority (59.7 %) had attended the ophthalmologist at least once in the preceding year, whereas 46.5 % and 34.2 % had visited the dentist/dental hygienist and podiatrist, respectively. Disposable household income increased attendance significantly, with a clear gradient in the OR of attending the dentist (p < 0.001), whereas age significantly magnified the OR of podiatrist and ophthalmologist attendance (p < 0.001). CONCLUSIONS This study provides circumstantial evidence that co-payment can increase inequality in health care attendance, especially for dental attendance, and it further shows that there is significant sociodemographic inequality in healthcare utilisation among people with type 2 diabetes.
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Affiliation(s)
- Dunia Hessain
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, 8200 Aarhus N, Denmark
| | - Anette Andersen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, 8200 Aarhus N, Denmark
| | - Eskild Klausen Fredslund
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, 8200 Aarhus N, Denmark.
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Nurminen M, Rättö H. Impact of diabetes diagnosis on dental care utilization: evidence from Finland. HEALTH ECONOMICS REVIEW 2023; 13:26. [PMID: 37129732 PMCID: PMC10152714 DOI: 10.1186/s13561-023-00440-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/20/2023] [Indexed: 05/03/2023]
Abstract
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.
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Affiliation(s)
- Mikko Nurminen
- Research Department, The Social Insurance Institution of Finland, P.O. Box 450, Helsinki, 00056, Finland.
| | - Hanna Rättö
- Research Department, The Social Insurance Institution of Finland, P.O. Box 450, Helsinki, 00056, Finland
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AlTuraiki AM, Jaemal HM, Alamer AA, Alghwainem AA, Althabit TA, Alamri A, Nazir MA. Oral Health and Patterns of Dental Visits Among Diabetic Patients in the Eastern Province of Saudi Arabia. Clin Cosmet Investig Dent 2021; 13:513-520. [PMID: 34887684 PMCID: PMC8653708 DOI: 10.2147/ccide.s340579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/24/2021] [Indexed: 12/03/2022] Open
Abstract
Purpose Diabetes is a big public health threat in Saudi Arabia. However, there is limited evidence about dental problems, oral hygiene practices, and dental visits among diabetic patients. The study aimed to evaluate self-perceived oral health status and patterns of dental attendance among diabetic patients in the Eastern province of Saudi Arabia. Methodology This cross-sectional study included 486 diabetic patients (mean age 50.14±13.59 years) registered with the Saudi Diabetes Society, Saudi Arabia (October–November 2020). The World Health Organization’s oral health questionnaire for adults was administered to collect information about oral health status, oral hygiene practices, and dental attendance, in addition to sociodemographic data. Descriptive and analytical statistics were performed. Results Most participants (66.3%) reported having dental pain or discomfort during the last year. Bad breath (60.50%), tooth cavities (55.10%), difficulty in biting hard food (55.10%), tooth sensitivity (53.30%), and bleeding gums (52.90%) were common oral problems among participants. More than half the sample (55.1%) reported visiting the dental office during the last year. However, pain or trouble with teeth, gums or mouth was the most common (40.5%) reason for the last dental visit. Only 7.8% of participants visited the dentist for a routine dental check-up. Multiple logistic regression analysis showed that Saudi nationality (AOR 2.68, P 0.008), family history of diabetes (AOR 1.88, P 0.022), and having pain during the last year (AOR 4.01, P <0.001) were the significant factors associated with the last dental visit due to pain. Conclusion This sample of participants demonstrated a high prevalence of dental problems. Few participants performed routine dental visits and most visits were due to pain. Saudis and patients with family history of diabetes and dental pain were more likely to perform pain related dental visits. Multidisciplinary efforts are needed to develop and implement preventive educational and clinical care models for positive oral and general health outcomes.
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Affiliation(s)
| | | | - Ali Ameen Alamer
- College of Dentistry Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ali Ahmed Alghwainem
- College of Dentistry Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Abdulaziz Alamri
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Muhammad Ashraf Nazir
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Tuncer E, Darby I. Knowledge and attitudes towards periodontal health among Australians diagnosed with diabetes. Aust J Prim Health 2021; 27:509-513. [PMID: 34823646 DOI: 10.1071/py20311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 06/08/2021] [Indexed: 12/20/2022]
Abstract
Diabetes and periodontitis are two major diseases affecting the Australian population. Despite the established interrelationship between the diseases, the knowledge of people with diabetes about this interrelationship is limited. This study investigated the knowledge of individuals with diabetes towards periodontal health in Australia. Adults diagnosed with diabetes participated in a survey asking about demographics, medical history, symptoms in the oral cavity, oral hygiene, attendance at the dentist and their knowledge of the interactions between periodontal disease and diabetes. The survey was completed by 113 participants, most of whom thought their diabetes was well controlled. Over half reported bleeding on brushing and one-third reported swollen gums. More than half (53.6%) the respondents were unaware of any complications of diabetes associated with the oral cavity, especially periodontal disease. Most respondents did not talk to their dentist about diabetes (53.6%), yet most wanted to know more about the effects of diabetes on gum health (75.3%). These findings demonstrate that, in this survey, adult Australians diagnosed with diabetes have limited knowledge about how periodontal disease affects them. These individuals, who are at a higher risk of periodontal disease, need to be better informed of the established bidirectional relationship between diabetes and oral health by all health professionals.
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Affiliation(s)
- Eren Tuncer
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, Vic. 3053, Australia
| | - Ivan Darby
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, Vic. 3053, Australia; and Corresponding author.
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Dental services use before and after inpatient admission among privately insured adults in the United States. J Am Dent Assoc 2021; 152:991-997. [PMID: 34489069 DOI: 10.1016/j.adaj.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/30/2021] [Accepted: 06/03/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Oral health has been connected to worse outcomes among hospitalized patients, but access to oral health care services in the hospital setting is limited. It is unknown how a hospital admission affects subsequent dental services use. METHODS The authors conducted a retrospective analysis of insurance claims data from a national private insurer. Patients were included if they were admitted to the hospital and had visited a dentist at least once in the year before or after admission. Total number of dental visits, as well as Code on Dental Procedures and Nomenclature codes associated with these visits in the year before and after a hospital stay, patient demographic characteristics, hospital admission diagnosis, and length of stay were recorded. Differences in dental services use before and after the hospital stay were calculated. RESULTS In total, 107,116 patients met inclusion criteria. There were fewer dental visits after admission (mean [standard deviation {SD}] 1.6 [1.7] than before admission (mean [SD] 1.9 [1.8]; P < .0001). Fewer procedures were recorded in the year after discharge (mean [SD] 7.0 [11.4] total Code on Dental Procedures and Nomenclature codes versus 8.5 [12.5] in the year before admission; P < .0001). The number of diagnostic and restorative services delivered was higher after admission, and the number of periodontic, endodontic, oral surgery, and prosthodontic services decreased (overall Pearson χ2, P < .0001). CONCLUSIONS Patients are less likely to visit a dentist after a hospital stay, although impact on oral health is unknown. PRACTICAL IMPLICATIONS Hospitalization may contribute to already existing oral health disparities. Hospital teams and dentists should work together to enhance access to oral health care after hospital admission.
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Borgnakke WS, Poudel P. Diabetes and Oral Health: Summary of Current Scientific Evidence for Why Transdisciplinary Collaboration Is Needed. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.709831] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This Perspective provides a brief summary of the scientific evidence for the often two-way links between hyperglycemia, including manifest diabetes mellitus (DM), and oral health. It delivers in a nutshell examples of current scientific evidence for the following oral manifestations of hyperglycemia, along with any available evidence for effect in the opposite direction: periodontal diseases, caries/periapical periodontitis, tooth loss, peri-implantitis, dry mouth (xerostomia/hyposalivation), dysbiosis in the oral microbiome, candidiasis, taste disturbances, burning mouth syndrome, cancer, traumatic ulcers, infections of oral wounds, delayed wound healing, melanin pigmentation, fissured tongue, benign migratory glossitis (geographic tongue), temporomandibular disorders, and osteonecrosis of the jaw. Evidence for effects on quality of life will also be reported. This condensed overview delivers the rationale and sets the stage for the urgent need for delivery of oral and general health care in patient-centered transdisciplinary collaboration for early detection and management of both hyperglycemia and oral diseases to improve quality of life.
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Access to healthcare services between insured and uninsured adults aged ≥50 years with diabetes in Mexico: the Mexican Health and Aging Study (MHAS-2018). Public Health 2021; 194:176-181. [PMID: 33962093 DOI: 10.1016/j.puhe.2021.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 01/11/2021] [Accepted: 03/03/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Analyze the association between health insurance coverage and the use of health care services, dentist visits, and self-medication in a national sample of Mexican adults aged ≥50 years with diabetes. METHODS Participants with diabetes taken from a subsample of the Mexican Health and Aging Study (MHAS-2018) (n = 3667) were examined, with data pertaining to the frequency of their doctor and dentist visits, residence, years of education, self-medication, and health insurance coverage (insured/uninsured) also collected. A logistic regression model was used to identify the association between independent variables and health insurance coverage, whereas Poisson regression models were also estimated to ascertain whether health insurance coverage was associated with the number of doctor and dentist visits. RESULTS The prevalence of self-reported diabetes was 24.6%, whereas approximately 93.3% of subjects had visited a doctor, 40.6% had visited a dentist, and 20.3% self-medicated. Individuals with insurance coverage were 75% (Odds ratio [OR] = 1.75 [95% confidence interval {CI}1.32-2.31]; P < 0.001) more likely to have visited a doctor and 57% more likely to have visited a dentist (OR = 1.57 [95% CI 1.35-1.83]; P < 0.001) than uninsured adult subjects, while adults living in rural areas were 77% less likely to be insured than adults living in urban areas. Doctor and dentist visits [rate ratio {RR} = 1.32 (95% CI 1.28-1.35); P < 0.001] and [RR = 1.47 (95% CI 1.37-1.58); P < 0.001, respectively] were found to be positively associated with the insured members of the study population. CONCLUSION A positive association was found between doctor and dentist visits in the population insured with diabetes. A major public health challenge is the population of diabetics who report being uninsured, wherein this population requires coverage to access the necessary clinical follow-up and control to prevent complications.
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Verhulst MJL, Teeuw WJ, Gerdes VEA, Loos BG. Implementation of an Oral Care Protocol for Primary Diabetes Care: A Pilot Cluster-Randomized Controlled Trial. Ann Fam Med 2021; 19:197-206. [PMID: 34180838 PMCID: PMC8118494 DOI: 10.1370/afm.2645] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 07/19/2020] [Accepted: 08/27/2020] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Although diabetes care guidelines recommend paying attention to oral health, the effect on daily practice has been limited, and patients with diabetes have yet to benefit. We investigated whether implementation of an oral care protocol for general practitioners (GPs [family physicians]) can improve patient-centered outcomes for patients with type 2 diabetes. METHODS Twenty-four GP offices were randomly assigned to the experimental or control group (12 offices each). In the experimental group, GPs and nurse practitioners implemented an oral care protocol. No extra attention was given to oral health in the control group. The primary outcome parameter was oral health-related quality of life (QoL) assessed with the 14-item Oral Health Impact Profile at baseline and 1 year later. Other outcomes were self-reported oral health complaints and general health-related QoL (36-item Short Form Health Survey). RESULTS Of 764 patients with type 2 diabetes, 543 (71.1%) completed the 1-year follow-up. More patients reported improved oral health-related QoL in the experimental group (35.2%) compared to the control group (25.9%) (P = .046; Padj = .049). In a secondary post hoc analysis including GP offices with ≥60% patient follow-up (n = 18), improvement was 38.3% and 24.9%, respectively (P and Padj = .011). Improvement of self-reported oral health complaints did not differ between groups. The intervention had no effect on general health-related QoL, with the exception of the concept scale score for changes in health over time (Padj = .033). CONCLUSIONS Implementation of an oral care protocol in primary diabetes care improved oral health-related QoL in patients with type 2 diabetes.
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Affiliation(s)
- Martijn J L Verhulst
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Wijnand J Teeuw
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Victor E A Gerdes
- Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
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Poudel P, Griffiths R, Arora A, Wong VW, Flack JR, Barker G, George A. Oral Health Status, Knowledge, and Behaviours of People with Diabetes in Sydney, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073464. [PMID: 33810479 PMCID: PMC8037358 DOI: 10.3390/ijerph18073464] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/22/2021] [Accepted: 03/25/2021] [Indexed: 12/15/2022]
Abstract
This study assessed self-reported oral health status, knowledge, and behaviours of people living with diabetes along with barriers and facilitators in accessing dental care. A cross sectional survey of 260 patients from four public diabetes clinics in Sydney, Australia was undertaken using a 35-item questionnaire. Data were analysed using SPSS software with descriptive and logistic regression analyses. More than half (53.1%) of respondents reported having dental problems which negatively impacted their related quality of life. Less than half (45%) had adequate oral health knowledge. Only 10.8% reported receiving any oral health information in diabetes care settings, which had higher odds of demonstrating adequate oral health knowledge (AOR, 2.60; 95% CI, 1.06-6.34). Similarly, 62.7% reported seeing a dentist in the last 12 months. Having private health insurance (AOR, 3.70; 95% CI, 1.85-7.40) had higher odds of seeing a dentist in the past 12 months. Dental costs were a major contributor to avoiding or delaying dental visit. Patients living with diabetes have unmet oral health needs particularly around the awareness of its importance and access to affordable dental services. Diabetes care providers can play a crucial role in this area by promoting oral health to their patients.
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Affiliation(s)
- Prakash Poudel
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool, NSW 2170, Australia;
- School of Nursing & Midwifery, Western Sydney University, Campbelltown, NSW 2560, Australia;
- South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; (V.W.W.); (J.R.F.)
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
- Correspondence:
| | - Rhonda Griffiths
- School of Nursing & Midwifery, Western Sydney University, Campbelltown, NSW 2560, Australia;
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Campbelltown, NSW 2751, Australia;
- Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW 2010, Australia
| | - Vincent W. Wong
- South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; (V.W.W.); (J.R.F.)
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
- Faculty of Medicine, University of New South Wales, Kensington, NSW 2052, Australia
| | - Jeff R. Flack
- South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; (V.W.W.); (J.R.F.)
- Faculty of Medicine, University of New South Wales, Kensington, NSW 2052, Australia
- Diabetes Centre Bankstown-Lidcombe Hospital, Bankstown, NSW 2200, Australia
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
| | - George Barker
- Diabetes Education Service, Hornsby-Ku-ring-gai Hospital, Northern Sydney Local Health District, Hornsby, NSW 2077, Australia;
| | - Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool, NSW 2170, Australia;
- School of Nursing & Midwifery, Western Sydney University, Campbelltown, NSW 2560, Australia;
- South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; (V.W.W.); (J.R.F.)
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia
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Kudoh R, Shibayama T, Hidaka K. The role of knowledge and self-efficacy on dental consultation behavior of patients with type 2 diabetes. Jpn J Nurs Sci 2020; 18:e12378. [PMID: 33164341 DOI: 10.1111/jjns.12378] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 07/28/2020] [Accepted: 08/08/2020] [Indexed: 11/30/2022]
Abstract
AIM This study aimed to examine the association of knowledge and self-efficacy as variables for behavior related to dental consultations among patients with type 2 diabetes, depending on the diagnosis of periodontal disease at a general hospital in Japan. METHODS A cross-sectional survey was conducted with 198 patients with type 2 diabetes (mean age: 66.1 ± 10.1 years, men: 56.6%, mean glycated hemoglobin: 7.3 ± 1.0%). The self-efficacy of patients with periodontal disease was assessed using the Self-Efficacy Scale for Self-Care. Knowledge was measured using five dichotomous items based on reference to clinical guidelines. Dental consultation behavior was assessed from regular dental checkup behavior. RESULTS In total, 31.8% of participants attended their regular dental checkup in the last year. Logistic regression analysis revealed that dental consultation behavior was positively associated with self-efficacy among patients diagnosed with periodontal disease (odds ratio [OR] = 1.26, 95% confidence interval [CI]: 1.10-1.45), and positively associated with the knowledge among patients not diagnosed with periodontal disease (OR = 1.54, 95%, CI: 1.09 - 2.16). CONCLUSION Patients without periodontal disease need to learn about accurate knowledge regarding periodontal disease as a complication of diabetes and its prevention via dental checkups. Supportive consultation to improve self-efficacy with respect to dental consultations should be offered to patients with periodontal disease. Medical professionals will be able to support each patient with type 2 diabetes by changing the educational approach for promoting regular dental checkups at the time of diabetes consultations.
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Affiliation(s)
- Rie Kudoh
- University of Tsukuba Graduate School of Comprehensive Human Sciences Doctoral Program in Nursing Science, Ibaraki, Japan
| | | | - Kikue Hidaka
- Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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Sahile AT, Mgutshini T, Ayehu SM. Oral Health Screening Status of Diabetes Patients in Selected Hospitals of Addis Ababa, Ethiopia, 2018. Patient Relat Outcome Meas 2020; 11:173-180. [PMID: 33061726 PMCID: PMC7519413 DOI: 10.2147/prom.s269292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 08/21/2020] [Indexed: 11/23/2022] Open
Abstract
Objective The study assessed the oral health screening status of diabetes patients and its associated factors in selected public hospitals of Addis Ababa, 2018. Patients and Methods An institutional-based cross-sectional study was conducted on 388 diabetes patients selected on the bases of a systematic random sampling method from March to May 2018 at two selected public hospitals in Addis Ababa. Data were collected with a pre-tested, structured, and translated questionnaire. Bi-variable and multivariable logistics regression were undertaken to identify predictors of oral health screening among diabetes with their respective 95% CI and a p-value of less than 5% level of significance. Results The oral health screening status among diabetes patients in this study was 21.1%. The odds of having had an oral health screening was 82.4% higher in those with an educational status of college and above than those who cannot read and write and it was ten and five folds higher in participants with a monthly income of less than 750 birr than those with above 2,000 birr and those who brushed their tooth twice or more times a day than occasionally, respectively. The odds of having had an oral health screening was 17, four, and five folds higher among participants with perceived susceptibility, perceived severity, and benefit, respectively, whilst it was 8.8% lower in participants with a perceived barrier and it was as high as 19.782 times among participants with malocclusion. Conclusion A lower level of oral health screening was observed. A higher educational level, a lower monthly income, a higher frequency of tooth brushing per day, positive perceptions of susceptibility, severity, and benefits, and presence of malocclusions were statistically associated with a higher frequency of oral health screening. Concerned bodies were recommended to work on the identified predictors and improve the oral health screening of diabetes patients.
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Affiliation(s)
| | - Tennyson Mgutshini
- Department of Public Health, University of South Africa, Pretoria, South Africa
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Simon LE, Karhade DS, Tobey ML. Oral Health Status of Hospitalized Patients With Type 2 Diabetes. Diabetes Spectr 2020; 33:58-65. [PMID: 32116455 PMCID: PMC7026757 DOI: 10.2337/ds18-0089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Diabetes is associated with poor oral health, as well as reduced access to dental care. A large percentage of patients hospitalized in the United States carry a diagnosis of diabetes; however, the oral health status of patients with diabetes who are hospitalized is unknown. METHODS All patients meeting inclusion criteria on the general medicine service of a tertiary care hospital were invited to participate. Subjects were asked about their access to dental care and perceptions of their oral health. A dental hygienist conducted examinations, including decayed, missing, and filled teeth (DMFT) and periodontal screening and recording (PSR) indices on a subset of subjects. RESULTS The 105 subjects had a mean age of 69 ± 12 years and a median A1C of 7.5 ± 2.1%. Rates of comorbidity and polypharmacy were high. The mean number of DMFT was 23.0 ± 7.2, with 10.1 ± 7.2 missing teeth. Forty- four percent of subjects had a removable prosthesis. Sixty-eight percent had a PSR index ≥4 in at least one sextant, indicating moderate periodontal disease. CONCLUSION Rates of missing teeth, removable prostheses, and periodonal inflammation were high among hospitalized patients with diabetes, but patients did not perceive their oral health to be poor. Health care providers should be aware of the oral health risks of patients with diabetes during hospitalization, and dentists should consider screening patients with diabetes for recent hospitalization.
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Affiliation(s)
- Lisa E. Simon
- Harvard School of Dental Medicine, Boston, MA
- Harvard Medical School, Boston, MA
| | | | - Matthew L. Tobey
- Harvard Medical School, Boston, MA
- Massachusetts General Hospital, Boston, MA
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Simon L, Tobey M, Wilson M. Feasibility of integrating a dental hygienist into an inpatient medical team for patients with diabetes mellitus. J Public Health Dent 2019; 79:188-192. [DOI: 10.1111/jphd.12320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 11/08/2018] [Accepted: 03/22/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Lisa Simon
- Harvard School of Dental Medicine Boston MA USA
| | - Matthew Tobey
- Division of General Internal MedicineMassachusetts General Hospital Boston MA USA
| | - Marlena Wilson
- Division of DentistryMassachusetts General Hospital Boston MA USA
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Verhulst MJL, Teeuw WJ, Gerdes VEA, Loos BG. Self-reported oral health and quality of life in patients with type 2 diabetes mellitus in primary care: a multi-center cross-sectional study. Diabetes Metab Syndr Obes 2019; 12:883-899. [PMID: 31354324 PMCID: PMC6590843 DOI: 10.2147/dmso.s207087] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/03/2019] [Indexed: 12/17/2022] Open
Abstract
Background: Guidelines for primary diabetes care recommend to pay attention to oral health in patients with diabetes mellitus type 2 (T2DM). However, research about dental care utilization and the extent of problems regarding oral health in these patients is limited. Purpose: To assess self-reported oral health, general health-related quality of life (QoL) and oral health-related QoL in patients with T2DM who regularly attend a family physician office. Methods: Family physician offices were recruited in the area of Amsterdam, the Netherlands, as part of a cluster-randomized controlled trial. At these offices, patients with T2DM were included by family physicians and/or nurse practitioners. Patient data on general characteristics, self-reported oral health (including periodontitis), general health-related QoL (SF-36) and oral health-related QoL (OHIP-NL14) were collected. Results: Twenty-four family physician offices participated, who enrolled 764 patients with T2DM (mean age: 65.9±10.7 years, 56% male, 16% smoker). Almost 11% of the patients were metabolically poorly controlled (HbA1c >63 mmol/mol), 39% were obese (body mass index≥30 kg/m2), 37% had hypertension (systolic blood pressure ≥140 mmHg) and 44% had dyslipidemia (LDL-cholesterol >2.5 mmol/L). About a quarter (24%) reported not to visit a dentist regularly and 30% did not have dental insurance coverage. Furthermore, 16% of the patients were edentulous and having full dental prostheses, while 29% had a partial dental prosthesis. Pain in the mouth, dry mouth and bad breath were reported by 15%, 37% and 12% of the patients, respectively. Almost 70% suffered from periodontitis. Oral health-related QoL was impaired in 19% of the patients, and those subjects also had worse general health-related QoL. Conclusion: Almost a quarter of patients with T2DM at Dutch family physician offices does not visit the dentist regularly. The estimated prevalence of periodontitis is particularly high, but other oral health complaints and impaired oral health-related QoL are also relatively common.
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Affiliation(s)
- Martijn JL Verhulst
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
- Correspondence: Martijn JL VerhulstDepartment of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The NetherlandsGustav Mahlerlaan 3004, Amsterdam, LA1081, The NetherlandsTel +3 120 598 0173Email
| | - Wijnand J Teeuw
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Victor EA Gerdes
- Department of Vascular Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
- Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
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16
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Myers-Wright N, Cheng B, Tafreshi SN, Lamster IB. A simple self-report health assessment questionnaire to identify oral diseases. Int Dent J 2018; 68:428-432. [DOI: 10.1111/idj.12398] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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17
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Poudel P, Griffiths R, Wong VW, Arora A, Flack JR, Khoo CL, George A. Oral health knowledge, attitudes and care practices of people with diabetes: a systematic review. BMC Public Health 2018; 18:577. [PMID: 29716561 PMCID: PMC5930945 DOI: 10.1186/s12889-018-5485-7] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 04/19/2018] [Indexed: 01/26/2023] Open
Abstract
Background People with uncontrolled diabetes are at greater risk for several oral health problems, particularly periodontal (gum) disease. Periodontal disease also impacts diabetes control. Good oral hygiene and regular dental visits are recommended to prevent and manage oral health problems. Several studies have been conducted to assess the oral health knowledge, attitudes, and practices of people with diabetes yet a review of these findings has not yet been undertaken. The aim of this systematic review was to synthesize current evidence on the knowledge, attitudes and practices of people with diabetes in relation to their oral health care. Methods A systematic search of all literature was carried out in five databases using key search terms. The inclusion criteria were: 1) published in the English language; 2) from 2000 to November, 2017; 3) conducted on persons with any type of diabetes and of all ages; 4) explored at least one study outcome (knowledge or attitude or practices toward oral health care); and 5) used quantitative methods of data collection. No restrictions were placed on the quality and setting of the study. Results A total of 28 studies met the inclusion criteria. The studies included a total of 27,894 people with diabetes and were conducted in 14 countries. The review found that people with diabetes have inadequate oral health knowledge, poor oral health attitudes, and fewer dental visits. They rarely receive oral health education and dental referrals from their care providers. Provision of oral health education by diabetes care providers and referral to dentists when required, was associated with improved oral health behaviours among patients. Conclusions Overall, people with diabetes have limited oral health knowledge and poor oral health behaviours. It is therefore essential to educate patients about their increased risk for oral health problems, motivate them for good oral health behaviours and facilitate access to dental care. Electronic supplementary material The online version of this article (10.1186/s12889-018-5485-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Prakash Poudel
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia. .,Centre for Oral Health Outcomes, Research Translation and Evaluation (COHORTE), Ingham Institute Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia. .,Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia. .,South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.
| | - Rhonda Griffiths
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia
| | - Vincent W Wong
- Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia.,South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Amit Arora
- Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia.,South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.,School of Science and Health, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia.,Oral Health Services and Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, 2010, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, Westmead, NSW, 2145, Australia
| | - Jeff R Flack
- South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, 2052, Australia.,School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 1797, Australia
| | - Chee L Khoo
- Health Focus Family Practice, The Royal Australian College of General Practitioners (RACGP), National Association of Diabetes Centres (NADC), Ingleburn, NSW, 2565, Australia.,Diabetes , Obesity and Metabolism Translational Research Unit (DOMTRU), Western Sydney University, Campbelltown, NSW, 2560, Australia
| | - Ajesh George
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia.,Centre for Oral Health Outcomes, Research Translation and Evaluation (COHORTE), Ingham Institute Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia.,Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia.,South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.,Faculty of Dentistry, University of Sydney, Camperdown, 2050, NSW, Australia.,Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia
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Luo H, Bell RA, Wright W, Wu Q, Wu B. Trends in annual dental visits among US dentate adults with and without self-reported diabetes and prediabetes, 2004-2014. J Am Dent Assoc 2018; 149:460-469. [PMID: 29615188 DOI: 10.1016/j.adaj.2018.01.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 01/07/2018] [Accepted: 01/08/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND The authors assessed the trends of annual dental visits in dentate adults with diabetes or prediabetes or no diabetes, and assessed whether the racial and ethnic disparities in dental visits changed from 2004 through 2014. METHODS Data for this analysis came from the Behavioral Risk Factor Surveillance System, a US health survey that looks at behavioral risk factors that was developed by the Centers for Disease Control and Prevention in cooperation with state health departments. Respondents indicated whether they had a dental visit in the past 12 months. Weighted proportions were calculated for annual dental visits in adults by diabetes status, and trends were assessed by racial and ethnic groups. RESULTS From 2004 through 2014, the proportion of annual dental visits declined from 66.1% to 61.4% (trend P = .02) in the diabetes group, 71.9% to 66.5% (trend P = .01) in the no diabetes group, and 66.0% to 64.9% (trend P = .33) in the prediabetes group. Age, income, and health insurance were moderators of the association between diabetes status and dental visits. Overall, the racial and ethnic disparity in dental visits did not change significantly during the period. CONCLUSIONS Dental visits and services were less frequent in people with diabetes and prediabetes. Racial and ethnic disparities in use of dental services persisted during the observed period. PRACTICAL IMPLICATIONS All patients, especially those with diabetes, are encouraged to visit a dentist at least annually. It is important for health care providers, such as primary care physicians and dental care and public health professionals, to make concerted efforts to promote oral health care in diabetes management. Improving access to dental services is vital to achieving this goal.
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Myers-Wright N, Lamster IB, Jasek JP, Chamany S. Evaluation of medical and dental visits in New York City: Opportunities to identify persons with and at risk for diabetes mellitus in dental settings. Community Dent Oral Epidemiol 2017; 46:102-108. [DOI: 10.1111/cdoe.12334] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 08/07/2017] [Indexed: 12/17/2022]
Affiliation(s)
- Noreen Myers-Wright
- Department of Health Policy and Management; Mailman School of Public Health; Columbia University; New York NY USA
| | - Ira B. Lamster
- Department of Health Policy and Management; Mailman School of Public Health; Columbia University; New York NY USA
| | - John P. Jasek
- Bureau of Chronic Disease Prevention and Tobacco Control; New York City Department of Health and Mental Hygiene; New York NY USA
| | - Shadi Chamany
- Division of Prevention and Primary Care; New York City Department of Health and Mental Hygiene; New York NY USA
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20
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Kelekar U. Oral Health Matters in Bending the Cost Curve. WORLD MEDICAL & HEALTH POLICY 2017. [DOI: 10.1002/wmh3.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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21
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Hastings JF, Vasquez E. Diabetes and Tooth Loss among Working-Age African Americans: A National Perspective. SOCIAL WORK IN PUBLIC HEALTH 2017; 32:443-451. [PMID: 28796580 PMCID: PMC5881378 DOI: 10.1080/19371918.2017.1358126] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Natural teeth are still lost in adults despite improvements in dental care and access to treatment across the life span. The study examined whether tooth loss can be mitigated in adults experiencing diabetes. National online survey data from the Service Utilization among African Americans with Co-morbid Depression and Diabetes (n = 275) were analyzed using logistic regression analyses. Diabetes was most prevalent among men (73.5%) and least prevalent among women (40.6%). In general and among the women, those without diabetes have approximately 50% fewer missing teeth than those with diabetes (odds ratio = .50; 95% confidence interval: 0.30, 0.83). Tooth loss is a traumatic experience and a serious life event that requires professional attention.
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Affiliation(s)
- Julia F. Hastings
- Health Policy, Management, & Behavior, School of Public Health, University at Albany, State University of New York, Rensselaer, New York, USA
| | - Elizabeth Vasquez
- Epidemiology, School of Public Health, University at Albany, State University of New York, Rensselaer, New York, USA
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Association Between Employee Dental Claims, Health Risks, Workplace Productivity, and Preventive Services Compliance. J Occup Environ Med 2017; 59:721-726. [DOI: 10.1097/jom.0000000000001069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Khan S, Saub R, Vaithilingam RD, Safii SH, Vethakkan SR, Baharuddin NA. Prevalence of chronic periodontitis in an obese population: a preliminary study. BMC Oral Health 2015; 15:114. [PMID: 26419358 PMCID: PMC4589070 DOI: 10.1186/s12903-015-0098-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 09/18/2015] [Indexed: 04/28/2023] Open
Abstract
Background Chronic periodontitis (CP) is a global public health issue. Studies have suggested CP could be linked to obesity due to their similar pathophysiological pathway. The aim of this study is to determine the prevalence of CP and to assess the predictors for CP among the obese Malaysian population. Methods This is a cross-sectional study on obese participants. Obesity is defined as an individual who has Body Mass Index (BMI) ≥27.5 kg/m2. A convenience sampling method was used. A total of 165 paricipants were recruited. This study involved answering questionnaires, obtaining biometric and clinical measurements of Visible plaque index (VPI), Gingival bleeding index (GBI), Probing pocket depth (PPD) and Clinical attachment loss (CAL). Data analysis was carried out using SPSS statistical software (SPSS Inc., version 20, US). Results A total of 165 participants; 67 (40.6 %) males and 98 (59.4 %) females participated in the study. Mean age of the participants was 43.9 (±8.9). The prevalence of CP among the obese population was found to be 73.9 %. Out of this, 43 and 55 % were categorised as moderate and severe CP respectively. Around 64 % of participants had sites with CAL ≥4 mm and participants with sites with PPD ≥4 mm were reported to be 25 %. Around 83 % of the participants had sites with GBI ≥30 and 92 % of participants had sites with VPI ≥20 %. GBI and VPI were found to have significantly higher odds for CP. Conclusion Prevalence of CP was high among obese Malaysians. GBI and VPI were potential predictors for CP in this obese population.
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Affiliation(s)
- Shahrukh Khan
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia.
| | - Roslan Saub
- Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia.
| | - Rathna Devi Vaithilingam
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia.
| | - Syarida Hasnur Safii
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia.
| | | | - Nor Adinar Baharuddin
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia.
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Liu L, Zhang Y, Wu W, Cheng R. Characteristics of dental care-seeking behavior and related sociodemographic factors in a middle-aged and elderly population in northeast China. BMC Oral Health 2015; 15:66. [PMID: 26070786 PMCID: PMC4465149 DOI: 10.1186/s12903-015-0053-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 06/03/2015] [Indexed: 12/04/2022] Open
Abstract
Background The etiologies of oral disease are generally progressive and cumulative, such that compared with younger individuals, middle-aged and elderly people are at greater risk of active dental caries and periodontal disease risk. They usually suffer from multiple oral diseases, and obstacles to their use of dental care services are numerous. Objectives The objectives of this study were to investigate the characteristics of dental care-seeking behaviors and related sociodemographic factors in a middle-aged and elderly population in northeast China. Methods This was a cross-sectional study of 1188 subjects, including 792 middle-aged (35–44 years-old) and 396 elderly (65–74 years-old) residents of northeast China. Information on dental care-seeking behaviors and sociodemographic characteristics was collected during face-to-face structured interviews conducted between May and June 2010. Chi square tests, Ridit scoring, and multivariate logistic regression analysis were employed to characterize dental care-seeking behaviors and their associations with sociodemographic factors. Results A greater proportion of middle-aged participants reported a need for dental visits compared with the elderly participants (75.8 % vs. 60.9 %; P < 0.01), as did more urban that rural residents (P < 0.05). The majority of individuals in both the middle-aged and elderly groups obtained for dental care at their own expense, and they predominantly chose private dental clinics. Ridit analyses showed that education level and income were significantly associated with oral care in both middle-aged and elderly people (Ps < 0.05). In addition, logistic regression analysis indicated that rural residence was negatively associated with dental visits in both middle-aged (odds ratio = 0.649, 95 % confidence interval: 0.447–0.884) and elderly (odds ratio = 0.604, 95 % confidence interval: 0.394–0.924) individuals. Conclusion The rate of dental care visits is low in the middle-aged and elderly populations of northeast China. Among sociodemographic factors, education level and income are positively associated with dental care visits, and rural residence is negatively associated with the frequency of such visits.
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Affiliation(s)
- Lu Liu
- Department of Preventive Dentistry, School of Stomatology, China Medical University, Shenyang, 110002, China.
| | - Ying Zhang
- Department of Preventive Dentistry, School of Stomatology, China Medical University, Shenyang, 110002, China.
| | - Wei Wu
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, 110001, China.
| | - Ruibo Cheng
- Department of Preventive Dentistry, School of Stomatology, China Medical University, Shenyang, 110002, China.
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Marlow NM, Slate EH, Fernandes JK, Leite RS. Associations between health insurance and generalized periodontal disease in a study population of Gullah African Americans with type-2 diabetes. Community Dent Oral Epidemiol 2012; 41:40-7. [PMID: 22882563 DOI: 10.1111/j.1600-0528.2012.00737.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Accepted: 06/19/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To explore the relationship between health insurance status (Medicare, Medicaid, private, and uninsured) and generalized periodontal disease (GPD) among a study population (N = 245) of adult Gullah African Americans with type-2 diabetes mellitus (T2DM) ages <65 years. METHODS We used multivariable logistic regression to assess GPD [using three different and increasingly severe clinical assessments: 3, 4, and 5 mm clinical attachment level (CAL) at 30% of sites] according to health insurance status. RESULTS Prevalence of GPD was 33.06% for 3, 18.78% for 4, and 9.80% for 5 mm CAL. Age ranged 26-64 years (mean = 52.11, SD = 8.53, median = 53). Private insurance was most prevalent (39.59%), followed by uninsured (30.61%), Medicaid (16.33%), and Medicare (13.47%). Results showed increased odds (versus private insurance) for GPD at 3 mm among Medicaid (OR = 1.82, P = 0.2404), Medicare (OR = 3.34, P = 0.0103), and uninsured (OR = 1.96, P = 0.0956) groups; GPD at 4 mm among Medicaid (OR = 1.97, P = 0.3303), Medicare (OR = 5.02, P = 0.0121), and uninsured (OR = 3.38, P = 0.0319) groups; and GPD at 5 mm among Medicaid (OR = 1.21, P = 0.8507), Medicare (OR = 12.62, P = 0.0038), and uninsured (OR = 4.00, P = 0.0763) groups. CONCLUSIONS We observed substantial disparities for GPD severity among those without private health insurance even after adjusting for glycemic control, income, dental health behaviors, and other covariates. Improved insurance benefits as well as individualized oral health educational interventions may decrease GPD severity for this study population of younger (ages <65 years) Gullah African Americans with T2DM, particularly those with Medicare insurance.
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Marlow NM, Slate EH, Bandyopadhyay D, Fernandes JK, Leite RS. Health insurance status is associated with periodontal disease progression among Gullah African-Americans with type 2 diabetes mellitus. J Public Health Dent 2011; 71:143-51. [PMID: 21774138 PMCID: PMC4234040 DOI: 10.1111/j.1752-7325.2011.00243.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2023]
Abstract
OBJECTIVES Assess periodontal disease progression among GullahAfrican Americans with type 2 diabetes mellitus (T2DM) according to health insurance coverage. METHODS From an ongoing clinical trial among T2DM Gullah, we extracted a cohort that was previously enrolled in a cross-sectional study (N=93). Comparing prior exam to trial initiation, total tooth sites/person with periodontal disease progression events [evaluated separately: 2+ mm of clinical attachment loss (CAL), 2+ mm increased periodontal probing depths (PPD), bleeding on probing (BOP) emergence] were evaluated according to health insurance coverage using regression techniques appropriate for data with different counts of potential events per subject (varying tooth sites available). We used negative binomial regression techniques to account for overdispersion and fit multivariable models that also included baseline glycemic control (poor: glycated hemoglobin > OR =7 percent, well: glycated hemoglobin <7 percent), history of established periodontitis, age, gender, body mass index, annual income, and oral hygiene behaviors. Final models included health insurance status, other significant predictors, and any observed confounders. RESULTS Privately insured were most prevalent (41.94 percent), followed by uninsured (23.66 percent), Medicare (19.35 percent), and Medicaid (15.05 percent). Those with poor glycemic control (65.59 percent) were more prevalent than well-controlled (34.41 percent). CAL events ranged from 0 to 58.8 percent tooth sites/ person (11.83 +/- 12.44 percent), while PPD events ranged from 0 to 44.2 percent (8.66 +/- 10.97 percent) and BOP events ranged from 0 to 95.8 percent (23.65 +/- 17.21 percent). Rates of CAL events were increased among those who were uninsured [rate ratio (RR) = 1.75, P = 0.02], Medicare-insured (RR = 1.90, P = 0.03), and Medicaid-insured (RR = 1.89, P = 0.06). CONCLUSIONS Increased access to health care, including dental services, may achieve reduction in chronic periodontal disease progression (as determined by CAL) for this study population. These results are very timely given the March 2010 passing of the US healthcare reform bills.
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Affiliation(s)
- Nicole M Marlow
- Division of Biostatistics and Epidemiology, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
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