Oral health related quality of life in diabetic patients

Self- reported oral health and oral health- related quality of life among patients with diabetes mellitus in a tertiary health facility

BACKGROUND

Considering the inter-relationship between Diabetes Mellitus (DM) and oral tissues, assessment of oral health status in relation to glycemic control might be informative about the disease condition, which might be pivotal to appropriate management and ultimately improve life satisfaction. This study therefore aimed to assess the pattern of self-reported diabetes related oral conditions and oral health-related quality of life (OHRQoL) among patients with DM at the University College Hospital (UCH), Ibadan, Nigeria.

MATERIALS AND METHODS

A cross- sectional study using an interviewer administered questionnaire was conducted among in- and out- patients being managed for DM by the Endocrinology unit of the hospital. Data collected included bio-data, medical history, self-reported oral conditions and dental service utilisation. The impact of oral health related quality of life was measured using OHIP-14. Oral examination was done to assess oral mucosal lesions and their oral hygiene status. Data was analysed using SPSS 21.

RESULTS

Eighty-four patients with diabetes consisting 23 (27%) in-patients and 61 (63%) out-patients were enrolled. Males were 26(31%) and females 58(69%); their ages ranged from 22 to 88 years with a mean of 60.9 ± 12.8 years. Most (67%) of the participants had one or more self-reported oral complaints, dryness (20.4%) being the most common and bad breath (4.6%) as the least reported. Poor glycemic level was found to be higher among the in-patients (82%) with random blood glucose > 200 mg/dL during admission, compared to the out-patient participants (51%) who had fasting plasma glucose > 110 mg/dL. Their oral hygiene status was assessed using simplified oral hygiene index and documented as fair (65%), poor (25%) and good (10%). About two-thirds (61%) had ever visited a dentist, majorly due to toothache. Only the pain (21.9%) and physical disability (26.3%) components of OHIP-14 were mainly found to affect the participants' OHRQOL.

CONCLUSIONS

This study found high rate of self- reported DM related oral conditions notably oral dryness, and periodontal diseases particularly as teeth mobility and spontaneous exfoliation. Nonetheless, most of the study participants had fair OHRQoL while its physical pain, functional limitation and psychological disability components were most reported.

Oral health-related quality of life among diabetic patients: A cross-sectional controlled study

Introduction

Diabetes is a widespread chronic metabolic condition that has a significant negative influence on a person's sociopsychological, physical, and economic well-being. This study was designed to (1) measure the impact of oral health on quality of life (QoL) using the Oral Health Impact Profile-14 (OHIP-14) in association with other factors (age, gender, years of diabetes, level of education, smoking, presence of other conditions, oral complaints, and glycemic control) and (2) validate the Arabic version of the OHIP-14.

Materials and Methods

Diabetic and healthy participants completed a two-part survey including demographic characteristics OHIP-14 questionnaire.

Results

The sample consisted of 121 patients with type 2 diabetes mellitus and 146 healthy controls. Sociodemographic data, OHIP-14 questionnaires, and glycemic control data were collected. The data were statistically analyzed. The results showed that OHIP-14 was found to have sufficient reliability and validity in measuring life quality. Our study documented the effects of oral health complications on QoL among diabetics compared to controls. The type of diabetes had no effect on life quality. The highest OHIP-14 domain affected was functional limitation, while the lowest one was social handicap.

Conclusion

It was concluded that diabetes has a negative effect on life quality. Diabetic patients have unsatisfactory oral health, which affects their QoL. The OHIP-14 is a reliable and valuable instrument to measure life quality.

The effect of diabetes mellitus on oral health-related quality of life: A systematic review and meta-analysis study

Background

Diabetes mellitus is related to variable dental and oral complications like xerostomia and periodontal problems. Therefore, diabetes can affect the oral status and oral health-related quality of life (OHRQoL). A systematic review of evidence can determine the association between diabetes and OHRQoL. so, this study aimed to evaluate the effects of diabetes on OHRQoL.

Methods

After determining the PECO and eligible criteria, a comprehensive search was conducted in PubMed, Scopus, Web of Science, and Embase without any restriction. Further searches were performed in Google Scholar and reference lists of selected articles. Two independent reviewers carried out paper selection, data extraction, and quality assessment. A meta-analysis was conducted using a "random effect model" and the standardized mean difference of OHRQoL with a 95% confidence interval (CI) was reported as estimating pooled effect size.

Results

After screening 237 identified records, three case-control and ten cross-sectional studies met eligibility criteria. Two cross-sectional studies were excluded in the quality assessment phase and the rest of the studies have a low or moderate risk of bias. The pooled standardized mean difference between the case and the control groups was 0.148 (95% CI: -0.045 to 0.340).

Conclusion

Diabetes mellitus has no statistical significant association with OHRQoL. Nevertheless, based on the articles' review, it seems that diabetes can lead to functional limitations, physical pain, and psychological discomfort. Also, complications of diabetes adversely affect wellbeing. Hence dentists can play an essential role in the awareness of persons with diabetes about these problems and improve their OHRQoL.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022303038, identifier CRD42022303038.

Evaluation of oral health-related quality of life and its association with mental health status of patients with type 2 diabetes mellitus in the post-COVID-19 pandemic era: A study from Central Saudi Arabia

Background and objectives

The association between oral and mental health is reciprocal, in which poor oral health may lead to several mental health issues, especially among patients with diabetes. The present study evaluated oral health-related quality of life (OHRQOL) and its association with mental health conditions among patients with type 2 diabetes mellitus (T2DM) in central Saudi Arabia.

Methods

The Arabic version of the Oral Health Impact Profile-14 (OHIP-14) questionnaire and the Depression, Anxiety, and Stress Scale-21 Items (DASS-21) were used to assess the OHRQOL and mental health status of patients with diabetes. We utilized logistic regression analysis to identify the predictors of poor OHRQOL, and Spearman's correlation test to identify any correlations between OHIP-14 and overall DASS-21 scores, as well as each subscale.

Results

Of the 677 patients included in the present study, 52.7% had a poor OHRQOL, which was significantly higher (positive association) among patients with a longer duration of diabetes (adjusted odds ratio [AOR] = 3.31; 95% confidence interval [CI] = 1.96-4.17) and those who did not periodically monitor their oral health (AOR = 2.85; 95% CI = 1.76-3.89). Some forms (mild, moderate, severe, or extremely severe) of depression, anxiety, and stress were observed in 59.7, 71.1, and 67.1% of the participants, respectively. Furthermore, we found that the total OHRQOL scores had a significant positive association with depression (AOR = 2.32, 95% CI = 1.34-3.71, p = 0.001), anxiety (AOR = 1.81, 95% CI = 1.22-2.79, p = 0.003), and stress (AOR = 1.43, 95% CI = 1.14-2.19, p = 0.026).

Conclusion

The results of the present study suggest the importance of appropriate and targeted health education programs for T2DM patients to ensure periodic dental examinations and oral health. Additionally, we recommend counseling sessions for all T2DM patients with trained healthcare providers to improve their mental health status during follow-up visits at outpatient diabetes care centers.

Oral Hygiene practices and Oral Health Related Quality of Life observed in patients reporting to Dental Institution in North India during COVID-19 Pandemic

OBJECTIVE

The purpose of the study was to ascertain Oral Health Related Quality of Life (OHRQOL) and evaluate oralhygiene practices in patients visiting a dental institution during COVID-19 time.

MATERIALS AND METHODS

Face-to face interviews were conducted using a semi-structured close-ended questionnaire,assessing oral hygiene practices and self-reported oral problems perceived in last 6 months, using both Hindi and English version of Oral Health Impact Profile (OHIP-14) Questionnaire. Frequency distribution of oral hygiene practices were obtained, and Descriptive statistics computed the scores of OHIP-14. Kruskal-wallis test and Independent t-test were used to match the association of OHIP-14 with demographic variables. Multiple linear regression analysis was utilized to compute the association of OHIP-14 with independent variables, age and gender.

RESULTS

Subjective evaluation of OHRQOL (Oral Health Related Quality of Life) using OHIP-14 Porforma resulted in high score for physical pain and psychological discomfort but subjects expressed less discomfort in connection to functional limitation, physical disability, psychological discomfort, social disability and handicap domains of OHIP-14. With progressive increase in age OHRQOL worsened. Females had poor OHRQOL, with significant difference as compared to males. Gender and marital status observed variance in OHIP-14 with statistically significant difference (P <0.000).

CONCLUSION

More than two-third subjects preferred cleaning their teeth using toothbrush and toothpaste. Therefore, COVID-19 consequently impacted OHRQOL of the general population.

Type 2 diabetes and its characteristics are associated with poor oral health: findings from 60,590 senior women from the E3N study

BACKGROUND

Type 2 diabetes (T2D) has been identified as a risk factor for poor oral health, however, a limited number of oral health and T2D characteristics have been studied so far. We sought to assess T2D status, age at diagnosis, duration since diagnosis and treatment in relation to a variety of oral diseases.

METHODS

Cross-sectional data were analyzed from the E3N (Etude Epidémiologique auprès de femmes de l'Education Nationale) cohort study which enrolled 60,590 women. Participants self-reported oral health status, and T2D cases were identified using diabetes-specific questionnaires and drug reimbursement insurance databases. Multivariable-adjusted ORs and 95% CIs were estimated using logistic regression models.

RESULTS

The mean age (SD) of the women was 70 years (7.2), and 4.7% (n = 2857) had T2D. Compared to women without T2D, women with T2D were more likely to report a poor perceived oral health (OR 1.37 [95% CI 1.18, 1.60]), wearing dental prostheses (1.26 [1.14, 1.39]) and having problems of biting and chewing food (1.19 [1.07, 1.33]). In addition, for women with T2D the age at diagnosis (inversely) and the duration (positively) were associated with the likelihood to report poor oral health.

CONCLUSIONS

For women with T2D, duration and age at diagnosis are associated with wearing prostheses, problems of biting and chewing, periodontitis and gingivitis.

Oral health status and oral health-related quality of life among patients with type 2 diabetes mellitus in the United Arab Emirates: a matched case-control study

BACKGROUND

Nearly a quarter of the population in the UAE has type 2 diabetes mellitus (T2DM), and this medical condition is associated with poorer oral health. The effects on oral health-related quality of life (OHRQoL), however, have not been examined in this population. Therefore, the objective of this study was to assess the impact of oral health problems, such as caries and periodontitis, on OHRQoL among Arab patients with and without T2DM.

METHODS

This matched case-control study included 88 diabetic and 88 non-diabetic participants recruited from University Dental Hospital Sharjah and University Hospital Sharjah, UAE. Participants completed a sociodemographic questionnaire as well as the Oral Health Impact Profile short form (OHIP-14), which measures OHRQoL. Clinical examinations were conducted to assess participants' dental caries status, using the Decayed Missing Filled Teeth (DMFT) Index, and periodontal condition, via clinical attachment loss (CAL) dichotomized to CAL < 3 mm and CAL ≥3 mm. Linear regression models were used to identify the association among OHIP domains, clinical attachment loss, DMFT scores, and diabetes status.

RESULTS

The mean age of participants was 43.0 years. A significantly (p = 0.01) higher proportion of diabetic patients (23%) had a CAL ≥3 mm than non-diabetic patients (10%). No significant differences in OHIP scores were observed between diabetic and non-diabetic patients. The results of the linear regression suggested that irrespective of diabetic status, DMFT scores were significantly associated with physical disability, physical pain, psychological discomfort, and psychological disability, as well as total OHIP scores. CAL was significantly associated with the handicap domain. Among non-diabetic patients, OHIP scores were significantly associated with DMFT scores in five OHIP domains (functional limitation, physical disability, physical pain, psychological discomfort, psychological disability), as well as total OHIP scores. Among diabetic patients, CAL was significantly associated with both the social disability and handicap domains, while only the handicap domain reached statistical significance among non-diabetic patients.

CONCLUSIONS

Participants who had decayed teeth, irrespective of their diabetic status, reported substantial physical and psychological impacts on OHRQoL. CAL also had a significant impact on OHRQoL, being primarily associated with the OHIP handicap domain in both diabetic and non-diabetic patients.

Oral health status and impact on the oral health-related quality of life of Egyptian children and early adolescents with type-1 diabetes: a case-control study

OBJECTIVES

The purpose of the present study is to (1) evaluate the oral health-related quality of life (OHRQoL) among a group of Egyptian children and early adolescents with type-1 diabetes mellitus (T₁DM) aged from 8 to 14 years and the impact of individual, environmental, oral health care and biological independent predictors (2) assess oral health status (OHS) in terms of oral hygiene, caries experience, untreated carious cavities and gingival condition.

MATERIALS AND METHODS

A case-control investigation conducted on eligible 444 participants who have been assigned into four groups (two case groups included 125 children and 97 early adolescents with T₁DM and two matched control groups). The OHRQoL was measured using a validated structured CPQ_8-10 for children and CPQ_11-14 short-form questionnaires for early adolescents. The questionnaire comprised of four parts that represented the study independent variables. Descriptive data were analysed using Mann-Whitney U test for the non-parametric data. Pearson's correlations have been calculated to inspect the interrelation between metabolic disease control and study of different OHS representatives. Log-linear Poisson model regression analyses performed to determine associations between the OHRQoL and independent predictors.

RESULTS

The prevalence of dental caries (DT ≥ 1) in children with diabetes was 49.6% (75.3%). The worse GI mean and median scores were recorded among early adolescents with T₁DM [mean (SD) = 2.24 ± 0.61; median (IQR) = 2.3(1)]. The social well-being of CPQ domains was a prominent concern that negatively affected children and early adolescents' life aspects. A strong correlation between OHRQoL and the level of HbA_1c in the two diabetic groups (r = 0.69 for children's group and 0.74 for the early adolescent group) was observed. The final model of log-linear Poisson regression analysis demonstrated that the odds ratio (OR) of poor OHRQoL among children and early adolescents with poor metabolic control was 1.30 [95% CI 1.18-1.47] and 1.22 [95% CI 1.11-1.38] times more than those with good metabolic control do.

CONCLUSIONS

The overall self-reported OHRQL appears to be adversely affected by T₁DM especially among children and early adolescents with poor metabolic control. Socioeconomic status and oral health care demonstrate a significant impact on the OHRQoL; however, the effect was obvious in the diabetic and non-diabetic groups.

CLINICAL RELEVANCE

1. In Egypt, the number of new cases rises progressively in a retrospective survey to figure out the prevalence of T1DM among children and adolescents. The available data is limited regarding the incidence and prevalence of dental caries and gingival condition among Egyptian children and early adolescents. 2. The present study is a premier study that assesses the OHRQoL and studies the impact of the individual, environmental, biological and oral health care variables. 3. This study highlights the urgent need for improving the oral health status of diabetic children and adolescents and the necessity for qualified oral health education programs for children and parents. There is an intense need to reinforce the role of preventive oral hygiene measures.

Oral health status and associated lifestyle behaviors in a sample of Iranian adults: an exploratory household survey

BACKGROUND

Poor oral hygiene can lead to serious diseases, such as periodontitis, tooth decay, pain and discomfort in teeth or gums, infections, and loss of teeth. In Iran, adults aged 50 y and older are a high-risk group for oral health problems, and this age group will grow in the coming decades. Despite increasing attention on healthy aging, there is relatively less emphasis on oral hygiene and health-related problems. The present study investigated the oral health status of Iranian adults using the oral health self-assessment questionnaire (OHQ) developed by the World Health Organization (WHO).

METHODS

A population-based household survey of a sample of adults aged 18-65 y was conducted. In this study, the participants were recruited between May and October 2016 in Tabriz, Iran, and the study population was sampled using a multi-stage cluster sampling design. The WHO's OHQ for adults was used for measuring oral health status and oral hygiene behavior.

RESULTS

In total, 2310 respondents completed the survey. The mean age (SD) of the participants was 41.6(23.4) y. Males accounted for 48.8% of the participants. Of the 2310 respondents,187 (8.1%) individuals were edentulous, 152(20.7%) of whom were aged 51-65 y. Furthermore, 72.3% of those aged 51-65 y were dentate, and 50% of adults aged 51-65 y said they had 20 or more teeth. About one-third of the participants reported that they did not brush their teeth daily (23% of those aged 18-35 y,35.9% of those aged 36-50 y, and 44.6% for those aged 51-65 y). In the sample, 39.4% of individuals aged 18-35 y,34.1% of individuals aged 36-50 y, and 26.6% of individuals aged 51-65 y had visited a dentist less than 6 month ago. One-third of the participants consumed sweets and sugary drinks daily.

CONCLUSIONS

Although the majority of Iranian adults considered their oral health status good, only a small percentage of the sample visited their dentist regularly. Furthermore, visits to the dentist declined in accordance with increasing age, a time when the incidence of oral health problems may increase. Poor oral health may increase the risk of adverse health outcomes, particularly among the aging population.

Impact of General and Oral Complications of Diabetes Mellitus Type I on Lebanese Children's Quality of Life

Introduction

Diabetes mellitus type I (DM1) has been increasing at an alarming rate worldwide. Children suffering from this chronic disease are subject to a high risk of systemic and oral complications, due to their young age and the lack of awareness of the relation between diabetes and oral health.

Objective

The aim of this study is to evaluate the impact of oral and general complications of DM1 on the Lebanese children's quality of life. The goal was to assess the child's behavioral issues on the one hand and the oral issues on the other.

Materials and methods

About 37 diabetic Lebanese children aged between 6 and 12 years, recruited from the Chronic Care Center (CCC), answered two questionnaires, one related to the disease and the second related to the oral complications.

Results

A majority of the participants (81.1%) are aware of their disease, 73% know the importance of their treatment and 54.1% are able to control their glycemia; 45.9% are not annoyed with constantly carrying a monitor and 67.5% are bothered by their restricted diet. Only 5.4% of children isolate themselves.

Concerning the oral complications

About 83.8% of the children do not suffer from oral ulcers, 56.8% are caries-free, and 64.9% have completed their dental treatment; 89.2% do not complain while eating and 94.6% are not able to brush their teeth properly.

Conclusion

Diabetic patients are found to have good knowledge of the disease and its systemic complications but a little on their increased risk for oral diseases. In order to ensure a good quality of life for the diabetic children and their families, optimal control of diabetes, appropriate oral hygiene, and regular visits to the dentist must be respected.How to cite this article: Noueiri B, Nassif N, Ollek A. Impact of General and Oral Complications of Diabetes Mellitus Type I on Lebanese Children's Quality of Life. Int J Clin Pediatr Dent 2018;11(1):40-45.

Oral health knowledge, attitudes and care practices of people with diabetes: a systematic review

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.

Impact of well-controlled type 2 diabetes mellitus on quality of life of chronic periodontitis patients

Background:

The purpose of the study is to examine the quality of life (QoL) in chronic periodontitis (CP) patients associated with or not with well-controlled type 2 diabetes mellitus (DM2).

Materials and Methods:

Five hundred CP patients, 250 with DM2 (GDM2 group) and 250 age- and gender-matched controls without DM2 (GND), were enrolled in this cross-sectional case-controlled study from January to September 2015. They were interviewed by a QoL questionnaire (Functional Assessment of Chronic Illness Therapy-Fatigue) validated to Portuguese. Periodontal examinations were also performed to confirm CP: probing pocket depth and clinical attachment level must be >3 mm.

Results:

An association between the presence of DM2 and a high negative impact on QoL was observed. All domains in GDM2 patients presented mean values above 19. On the other hand, three functional domains in GND (physical, social/family, and emotional) showed values below 19 (medium negative impact). Comparisons between GND and GDM2 revealed the statistical difference between them for all domains (P < 0.05).

Conclusions:

This study shows that DM2 associated with CP negatively affect QoL, even considering well-controlled diabetic patients.